Jordan Holt Gray

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

5360 Issued in AL

Practice address

5751 Pocahontas Rd Ste a
Suite 5
Bessemer, AL 35022-5478

Phone

(205) 477-4242

Fax

(205) 477-4243

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1073607404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 POCAHONTAS ROAD",
            "address_2": "SUITE A",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350225478",
            "telephone_number": "205-477-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 POCAHONTAS RD STE A",
            "address_2": "SUITE 5",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350225478",
            "telephone_number": "205-477-4242",
            "fax_number": "205-477-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JORDAN",
        "middle_name": "HOLT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "AL",
            "license": "5360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "5360",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Anthony Gonzalez, M.D.
• Briana Gooden
• Jake Clinton Goodwin, OPTICIAN
• Kristian David Gratton, PA-C
• Corrie Graveman
• Ashleigh Green, RDN, LD
• Kimberly Michelle Green, DMD
• Jonathan Brady Greene, DMD
• Micheal Jason Grier, CRNP
• Caron Givhan Griffin, MSW

• Prosthodontics in Bessemer, AL
• Providers in Bessemer, AL by specialty
• Prosthodontics in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.