Kimberly Nicole Gray, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024190699 Issued in VA

Practice address

825 Fairfax Ave Ste 410
Norfolk, VA 23507-1914

Phone

(757) 446-8999

NPI assigned

Jul 15, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Evms Academic Physicians and Surgeons Health Services FoundationGroup PAC ID 5698675510, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgray856338@direct.sentara.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evms Academic Physicians and Surgeons Health Services Foundation

  dba EVMS Medical Group

  • Internal Medicine Physician
  • Norfolk, VA
  • NPI 1003887118
  Medicare reassignment Care Compare group NPD
• Foundations to Success, LLC

  • Community/Behavioral Health Agency
  • Newport News, VA
  • NPI 1538887898
  Medicare reassignment NPD
• Inner Balance and Wellness Psychiatric Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hampton, VA
  • NPI 1265251771
  NPD Authorized official
• Foundations to Success, LLC

  dba FTS Private Practices

  • Psychiatric/Mental Health Registered Nurse
  • Hampton, VA
  • NPI 1700779303
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1003654179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE STE 410",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE STE 410",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-8999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Howmet Dr",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236611001",
            "country_code": "US",
            "telephone_number": "757-782-2181",
            "fax_number": "757-765-6109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001242681",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024190699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael NMN Grassia, MD
• Brandon Dion Gray
• Brittany Gray, LMHP-R
• Erin Anne Gray
• Janice Gray, LPC, CEAP, LMFT
• Kyle Gray, MD
• L Layla Gray, LPC
• Teayra Gray, LPC, LCPC
• Patricia Graydon, LCSW
• Janine Louise Grayson, D.C

• Psychiatric/Mental Health Nurse Practitioner in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.