Latoya Gray

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN282463 Issued in GA

Practice address

805 Lanier Ave E
Fayetteville, GA 30214-2204

Phone

(770) 694-6349

NPI assigned

Mar 10, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Avant Behavioral Consultants Inc 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Avant Behavioral Consultants Inc

  • Psychiatry Physician
  • Austell, GA
  • NPI 1598250342

  GA

  Medicare reassignment Care Compare group NPD
• Clearminds Behavioral Health LLC

  • Psychiatry Physician
  • Palo Alto, CA
  • NPI 1437833753

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1104625508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 LANIER AVE E",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142204",
            "telephone_number": "770-694-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 LANIER AVE E",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142204",
            "telephone_number": "770-694-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LATOYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN282463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael W Granger, DMD
• Ann Marie Coleman Grant, CCC-SLP
• Kennedy Grant, RBT
• Priscella Grant
• Skylar Rose Grant
• Sharmane Marie Gray, MD
• Charlotte Elizabeth Grayson- Mathis, M.D.
• Christa Grayson, CADC-II
• Greater Atlanta Youth Development Corporation
• Greater Georgia Behavioral Health

• All providers in Fayetteville, GA
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.