CLYDE GRADY NPI 1851484075

NPI Information

  • NPI: 1851484075
  • Provider Name: CLYDE GRADY
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 104 S BROAD ST
    KNOXVILLE, IL
    ZIP 61448
  • Phone: (309) 289-2335

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NPI Details

Clyde Grady is a family medicine in Knoxville, IL with 31 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Clyde Grady NPI is 1851484075. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

104 S BROAD ST
KNOXVILLE, IL
ZIP 61448-339
Phone: (309) 289-2335
Fax: (309) 289-8196

The NPI 1851484075 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Blood test, clotting time (HCPCS:85610)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Hemoglobin a1c level (HCPCS:83036)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Automated urinalysis test (HCPCS:81003)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza (HCPCS:87428)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
  • Telephone medical discussion with physician, 11-20 minutes (HCPCS:99442)
  • Pneumococcal vaccine, 23-valent (HCPCS:90732)
  • Urinalysis, manual test (HCPCS:81002)

The enumeration date for this NPI number is 10/2/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CB6569MEDICARE ID-TYPE UNSPECIFIEDILLINOISRR GROUP #
2L64961MEDICARE ID-TYPE UNSPECIFIEDILLINOISINDIVIDUAL #
3833600MEDICARE ID-TYPE UNSPECIFIEDILLINOISGROUP #
4G14513MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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