Individual provider Active NPI

Lee V Gray III, M.D.

  • Nephrology Physician
  • Huntersville, NC
National Provider Identifier
1114145554
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
200400340 Issued in NC
Practice address
16511 Northcross Dr Ste a
Huntersville, NC 28078-5021
Phone
(704) 896-3313
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 200400340 NC Primary

Addresses

Primary practice location

16511 Northcross Dr Ste a
Huntersville, NC 28078-5021

Mailing address

16511 Northcross Dr Ste a
Huntersville, NC 28078-5021
Phone (704) 896-3313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050311000449 NC Practitioner - Internal MedicinePractitioner - General Practice 7113971144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pain Clinic of North Carolina PAGroup PAC ID 6406110733, 4 clinicians

Practice addresses (Care Compare)

16511 -A Northcross Dr
Huntersville, NC 28078-5021
Phone (704) 896-3313

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Clinic of North Carolina, PA CurrentSince Dec 1, 2012 Accepting new patients

Locations

16511 Northcross Dr
Ste A
Huntersville, NC 28078
Phone (704) 896-3313

1112 Yancey St
Shelby, NC 28150
Phone (704) 481-0171

1503 E Broad St
Statesville, NC 28625
Phone (704) 871-9731

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBBFBD/Endpoint/CBBFBD

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.

Hospital & facility affiliations 1

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1114145554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16511 NORTHCROSS DR STE A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785021",
            "telephone_number": "704-896-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16511 NORTHCROSS DR STE A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785021",
            "telephone_number": "704-896-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LEE",
        "middle_name": "V",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "200400340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.