Grayson Massey Gravely, PA-C
Individual provider Active NPI Physician Assistant · Benson, NC
NPI 1124520440 · NPPES record last updated Sep 14, 2023
Key facts
- NPI
- 1124520440
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-07797 (NC)
- Practice address
- 1 Medical Dr
Benson, NC 27504-1177 - Phone
- (919) 894-1740
- Fax
- (919) 894-2701
- NPI assigned
- Mar 2, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Advanced Spine and Pain Center, P.a.
Practice addresses (Care Compare)
1 Medical Dr
Benson, NC 27504-1177
Phone (919) 894-1740
204 Medspring Dr
Suite 100
Clayton, NC 27520-9293
Phone (919) 359-8643
Hospital & facility affiliations
- Johnston Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180423000094 | NC | Practitioner - Physician Assistant | 4587927736 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Spine and Pain Center, P.a. | Current |
Accepting new patients |
Locations
1 Medical Dr
Benson, NC 27504
Phone (919) 207-1027
204 Medspring Dr
#100
Clayton, NC 27520
Phone (919) 359-8643
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-07797 | NC | Yes |
Addresses
Primary practice location
1 Medical Dr
Benson, NC 27504-1177
Mailing address
1 Medical Dr
Benson, NC 27504-1177
Phone (919) 894-1740
Other providers in Benson, NC
- Kyle D Flowers
- Foot and Ankle Specialists of the Mid-Atlantic, LLC
- Frost & Fyre
- Meg Melissa Gilbert
- Blair Judith Gilmer
- Mark Damian Greenwell
- Sara Mary Hall
- Healing Place of the Carolinas, the
- Thomas Page High
- Katie Thomas Hodges
All providers in Benson, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.