Active NPI
Allyson Rae Gray, LPN
- Licensed Practical Nurse
- Roanoke, VA
National Provider Identifier
1063669687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 0002051197
- Practice address
- 301 Elm Ave SW
Roanoke, VA 24016-4001 - Phone
- (540) 345-9841
- Fax
- (540) 527-8900
- NPI assigned
- Aug 26, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0002051197 | VA | Primary |
Addresses
Primary practice location
301 Elm Ave SW
Roanoke, VA 24016-4001
Mailing address
301 Elm Ave SW
Roanoke, VA 24016-4001
Phone (540) 345-9841
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437137734 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0002051197 | VA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1063669687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ELM AVE SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164001",
"telephone_number": "540-345-9841",
"fax_number": "540-527-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 ELM AVE SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164001",
"telephone_number": "540-345-9841",
"fax_number": "540-527-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "ALLYSON",
"middle_name": "RAE",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-26",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "VA",
"license": "0002051197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437137734",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.