Active NPI
Dianne Elaine Gray, ARNP
- Women's Health Nurse Practitioner
- Omak, WA
National Provider Identifier
1104954577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- AP30004405
- Practice address
- 127 N Juniper St
Omak, WA 98841-9337 - Phone
- (509) 422-6593
- Fax
- (509) 422-0907
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | AP30004405 | WA | Primary |
Addresses
Primary practice location
127 N Juniper St
Omak, WA 98841-9337
Mailing address
127 N Juniper St
Omak, WA 98841-9337
Phone (509) 422-6593
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7103203 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30004405 | WA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Okanogan Family Planning | 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.
-
- Ambulatory Family Planning Facility
- Omak, WA
- NPI 1760546899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104954577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 N JUNIPER ST",
"city": "OMAK",
"state": "WA",
"postal_code": "988419337",
"telephone_number": "509-422-6593",
"fax_number": "509-422-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 N JUNIPER ST",
"city": "OMAK",
"state": "WA",
"postal_code": "988419337",
"telephone_number": "509-422-6593",
"fax_number": "509-422-0907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DIANNE",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "WA",
"license": "AP30004405",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7103203",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omak, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.