NPIMap

Individual provider Active NPI

Phillip Gray, M.D.

  • Family Medicine Physician
  • Calhoun, GA
National Provider Identifier
1093786386
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
033340 Issued in GA
Practice address
105 Willowbrook Way SE
Calhoun, GA 30701-1404
Phone
(706) 625-6999
Fax
(706) 625-6990
NPI assigned
Jan 27, 2006
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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 033340 GA Primary

Addresses

Primary practice location

105 Willowbrook Way SE
Calhoun, GA 30701-1404

Mailing address

PO Box 12938
C/O Clinic Management
Calhoun, GA 30703

Other identifiers 1

IdentifierTypeStateIssuer
000461018EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100609000680 GA Practitioner - Family Practice 8527097658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians

Practice addresses (Care Compare)

400 Timms Rd NE
Calhoun, GA 30701-7016
Phone (706) 625-0022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
68.23
Promoting interoperability
100
Improvement activities
40
Cost
74.67

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Owasa Family Medicine Family Medicine Current Accepting new patients
Adventist Health System Georgia Inc CurrentSince May 2, 2016 Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

105 Willowbrook Way SE
Calhoun, GA 30701
Phone (706) 625-6999

109 Hospital Dr
Calhoun, GA 30701
Phone (706) 279-2635

400 Timms Rd NE
Calhoun, GA 30701
Phone (706) 625-0022

2112 Shorter Ave NW
Ste 200
Rome, GA 30165
Phone (706) 233-4000

160 Central Ave
Trion, GA 30753
Phone (706) 734-7302

Interoperability endpoints

  • Direct secure messaging: pgray661703@adventhealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1093786386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "C/O CLINIC MANAGEMENT",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "30703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WILLOWBROOK WAY SE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307011404",
            "telephone_number": "706-625-6999",
            "fax_number": "706-625-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "033340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000461018E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

Verify at the official NPI Registry.