Individual provider Active NPI

Cynthia Middleton Gray, FNP

  • Family Nurse Practitioner
  • Winnsboro, LA
National Provider Identifier
1104140987
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
03706 Issued in LA
Practice address
2106 Loop Rd
Winnsboro, LA 71295-3344
Phone
(318) 435-9411
Fax
(318) 435-3842
NPI assigned
Mar 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 03706 LA Primary

Addresses

Primary practice location

2106 Loop Rd
Winnsboro, LA 71295-3344

Mailing address

PO Box 1300
Winnsboro, LA 71295-1300
Phone (318) 435-9411

Other practice location 1

307 Chisum St
Sicily Island, LA 71368-4807
Phone (318) 389-5727 ext. 205

Other identifiers 1

IdentifierTypeStateIssuer
1378127MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20100301000817 LA Practitioner - Nurse Practitioner 2567359698 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franklin Parish Hospital Service Dist 1Group PAC ID 7810893302, 80 clinicians

Practice addresses (Care Compare)

2106 Loop Rd
Winnsboro, LA 71295-3344
Phone (318) 412-5265

Hospital & facility affiliations

  • Franklin Medical Center Hospital, Winnsboro, LA, CCN 190140
  • Richland Parish Hospital-Delhi Hospital, Delhi, LA, CCN 191323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
03706LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catahoula Parish Hospital District No 2 CurrentSince Aug 1, 2010 Accepting new patients
Franklin Parish Hospital Service Dist 1 CurrentSince Dec 3, 2018 Accepting new patients
Catahoula Parish Hospital District No 2 CurrentSince Aug 1, 2010 Accepting new patients
Franklin Parish Hospital Service Dist 1 CurrentSince Dec 3, 2018 Accepting new patients
Jimmy R Coughran a Medical Corporation CurrentSince May 9, 2015 Accepting new patients
Ronald J Morgan, a Professional Medical Corporation Past Accepting new patients
Hospital Service District No 1-a of the Parish of Richland State of la Past Accepting new patients
Franklin Parish Hospital Past Accepting new patients

Locations

1010 Davis Lake Rd
Columbia, LA 71418
Phone (318) 649-3766

104 Verona St
Newellton, LA 71357
Phone (318) 467-2349

448 Newton St
Saint Joseph, LA 71366
Phone (318) 412-5265

307 Chisum St
Sicily Island, LA 71368
Phone (318) 389-5727

5745 Highway 17
Winnsboro, LA 71295
Phone (318) 722-3333

2106 Loop Rd
Ste A
Winnsboro, LA 71295
Phone (318) 435-6363

2104 Loop Rd
Ste C
Winnsboro, LA 71295
Phone (318) 435-4571

2106 Loop Rd
Ste B
Winnsboro, LA 71295
Phone (318) 338-3540

2106 Loop Rd
Winnsboro, LA 71295
Phone (318) 282-8482

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1104140987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1300",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712951300",
            "telephone_number": "318-435-9411",
            "fax_number": "318-435-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 LOOP RD",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712953344",
            "telephone_number": "318-435-9411",
            "fax_number": "318-435-3842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Chisum St",
            "address_purpose": "LOCATION",
            "city": "Sicily Island",
            "state": "LA",
            "postal_code": "713684807",
            "country_code": "US",
            "telephone_number": "318-389-5727 x205",
            "fax_number": "318-389-4028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "replacement_npi": "1104140987",
        "last_name": "GRAY",
        "first_name": "CYNTHIA",
        "middle_name": "MIDDLETON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "03706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1378127",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnsboro, LA

Sources for this page

Verify at the official NPI Registry.