Timothy E Gray, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

370 Issued in MD

Practice address

1200 Creamery LN
Belcamp, MD 21017-1499

Phone

(443) 518-6559

NPI assigned

Nov 22, 2017

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 12, 2022.

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668211200000",
    "number": "1124532411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CREAMERY LN",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171499",
            "telephone_number": "434-518-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CREAMERY LN",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171499",
            "telephone_number": "443-518-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TIMOTHY",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2022-11-12",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.