Holly D'lana Von Gruenigen, DO is a medicare enrolled "Pediatrics" physician in Russell Springs, Kentucky. Her current practice location is
404 Steve Dr, Russell Springs, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(270) 866-3161.
Holly D'lana Von Gruenigen is licensed to practice in Kentucky (license number 03704) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215220827.
Physician's Profile
Full Name | Holly D'lana Von Gruenigen |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 404 Steve Dr, Russell Springs, Kentucky |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1215220827
- Provider Enumeration Date: 05/16/2011
- Last Update Date: 09/19/2019
Medicare PECOS Information:
- PECOS PAC ID: 2264659465
- Enrollment ID: I20140812001937
Medical Identifiers
Medical identifiers for Holly D'lana Von Gruenigen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215220827 | NPI | - | NPPES |
7100248610 | Medicaid | KY | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 03704 (Kentucky) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Holly D'lana Von Gruenigen allows following entities to bill medicare on her behalf.
Entity Name | Cumberland Family Medical Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306873500 PECOS PAC ID: 6305947789 Enrollment ID: O20120221000433 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holly D'lana Von Gruenigen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Holly D'lana Von Gruenigen, DO Po Box 1080, Burkesville, KY 42717-1080 Ph: (270) 864-1472 | Holly D'lana Von Gruenigen, DO 404 Steve Dr, Russell Springs, KY 42642-4622 Ph: (270) 866-3161 |
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