Active NPI
Charles McCray
- Child Mental Illness Respite Care
- Glendale, AZ
National Provider Identifier
1134296601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Mental Illness Respite Care
- License
- 9094
- Practice address
- 8225 W Tuckey LN
Glendale, AZ 85303-3210 - Phone
- (623) 463-1936
- NPI assigned
- Nov 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Child Mental Illness Respite Care | 385HR2055X | 9094 | AZ | Primary |
Addresses
Primary practice location
8225 W Tuckey LN
Glendale, AZ 85303-3210
Mailing address
8225 W Tuckey LN
Glendale, AZ 85303-3210
Phone (623) 463-1936
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 905903 | Other | AZ | AHCCCS ID |
Other names 1
- Marguerite McCray
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 |
|---|---|---|---|
| 9094 | AZ | MD | Child Mental Illness Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134296601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8225 W TUCKEY LN",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853033210",
"telephone_number": "623-463-1936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8225 W TUCKEY LN",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853033210",
"telephone_number": "623-463-1936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRAY",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "AZ",
"license": "9094",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS ID",
"identifier": "905903",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARGUERITE",
"last_name": "MCCRAY",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Glendale, AZ
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.