Individual provider Active NPI

Robert Gray, M.D.

  • Family Medicine Physician
  • Dover AFB, DE
National Provider Identifier
1043626187
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28844 Issued in NE
Practice address
300 Tuskegee Blvd
Dover AFB, DE 19902-5003
Phone
(302) 677-5799
NPI assigned
Jul 9, 2014
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28844 NE Primary

Addresses

Primary practice location

300 Tuskegee Blvd
Dover AFB, DE 19902-5003

Mailing address

300 Tuskegee Blvd
Dover AFB, DE 19902-5003
Phone (302) 677-5799

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
I20160323001102 FL Order and Referring Only - Family PracticePractitioner - Family Practice 3072810746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28844NEMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1043626187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TUSKEGEE BLVD",
            "city": "DOVER AFB",
            "state": "DE",
            "postal_code": "199025003",
            "telephone_number": "302-677-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TUSKEGEE BLVD",
            "city": "DOVER AFB",
            "state": "DE",
            "postal_code": "199025003",
            "telephone_number": "302-677-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "28844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover AFB, DE

Sources for this page

Verify at the official NPI Registry.