Individual provider Active NPI

Shayla Lillian-Smith Gray, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1033311238
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME99586 Issued in FL
Practice address
1616 Physicians Dr
Tallahassee, FL 32308-4619
Phone
(850) 461-5100
Fax
(850) 431-7478
NPI assigned
Jun 1, 2007
Last updated
Jun 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME99586 FL Primary
Family Medicine Physician 207Q00000X 245726 MA

Addresses

Primary practice location

1616 Physicians Dr
Tallahassee, FL 32308-4619

Mailing address

1616 Physicians Dr
Tallahassee, FL 32308-4619
Phone (850) 461-5100

Other identifiers 1

IdentifierTypeStateIssuer
281132400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000560 FL Practitioner - Family PracticePractitioner - General Practice 9739250176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1616 Physicians Dr
Tallahassee, FL 32308-4619
Phone (850) 431-5910

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
245726MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Jan 25, 2014 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jan 25, 2014 Accepting new patients

Locations

1301 Hodges Dr
Tallahassee, FL 32308
Phone (850) 431-5430

1309 Thomasville Rd
Tallahassee, FL 32303
Phone (850) 431-5910

1616 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-5105

Interoperability endpoints

  • Direct secure messaging: sgray21392@tallahasseememorial.direct-ci.com

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1033311238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 PHYSICIANS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084619",
            "telephone_number": "850-461-5100",
            "fax_number": "850-431-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 PHYSICIANS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084619",
            "telephone_number": "850-461-5100",
            "fax_number": "850-431-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHAYLA",
        "middle_name": "LILLIAN-SMITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME99586",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "245726",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281132400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.