Jennifer H Gray, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP168105 Issued in GA

Practice address

11 N College St
Statesboro, GA 30458-5306

Phone

(912) 764-9868

Fax

(912) 764-5066

NPI assigned

Aug 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Georgia Anesthesia and Pain Managment

  • Anesthesiology Physician
  • Statesboro, GA
  • NPI 1053419044
  Medicare reassignment NPD
• Pineland Area Community Services Board

  • Community/Behavioral Health Agency
  • Statesboro, GA
  • NPI 1588735252
  NPD
• Pineland Mental Health,Mental Retardation & Substance Abuse Services

  • Adult Mental Health Clinic/Center
  • Statesboro, GA
  • NPI 1780859439
  NPD (past)
• Pineland MH/Mr/Sa CSB

  • Clinic/Center
  • Vidalia, GA
  • NPI 1760658587
  NPD (past)

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1083962849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 N COLLEGE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-764-9868",
            "fax_number": "912-764-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N COLLEGE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585306",
            "telephone_number": "912-764-9868",
            "fax_number": "912-764-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Durden St",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304744608",
            "country_code": "US",
            "telephone_number": "912-537-9316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 N Brunswick St",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315464373",
            "country_code": "US",
            "telephone_number": "912-427-9338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP168105",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN168105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Brandon Gordon, DMD
• Donald Graham, D.O.
• Shelby Jordan Palmerton Graham, MSN, APRN, WHNP-BC
• Jillian Zofia Grantham
• Sarah Grantham, PT
• Ladaesha Green
• Kendall M Griffith, M.D.
• Guardian Pharmacy of Southeast Ga LLC
• Michael Gulasey
• Keith Gunnerson

• Family Nurse Practitioner in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.