Individual provider Active NPI

Cheryl Vanessa Gray, MD

  • Internal Medicine Physician
  • Chatsworth, CA
National Provider Identifier
1083748768
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G78007 Issued in CA
Practice address
9909 Topanga Canyon Blvd
Chatsworth, CA 91311-3602
Phone
(818) 426-3473
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G78007 CA Primary

Addresses

Primary practice location

9909 Topanga Canyon Blvd
Chatsworth, CA 91311-3602

Mailing address

9909 Topanga Canyon Blvd
Chatsworth, CA 91311-3602
Phone (818) 426-3473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241216002338 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9032191408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78007CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Picture and Television Fund Medical Group, Inc Internal Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1083748768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 TOPANGA CANYON BLVD",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113602",
            "telephone_number": "818-426-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 TOPANGA CANYON BLVD",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113602",
            "telephone_number": "818-426-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CHERYL",
        "middle_name": "VANESSA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G78007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, CA

Sources for this page

Verify at the official NPI Registry.