Active NPI
Elizabeth Gray, APRN-CNP
- Family Nurse Practitioner
- Kettering, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN.CNP.0028780
- Practice address
- 540 Lincoln Park Blvd Ste 200
Kettering, OH 45429-6403 - Phone
- (937) 298-8058
- NPI assigned
- Jul 22, 2021
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0028780 | OH | Primary |
Addresses
Primary practice location
540 Lincoln Park Blvd Ste 200
Kettering, OH 45429-6403
Mailing address
654 Tealwood Dr
Beavercreek, OH 45430-1623
Phone (413) 531-0306
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | egray634125@direct.ketteringhealth.org | ||
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2510 Commons Blvd
Suite 125
Beavercreek, OH 45431-3835
Phone (937) 454-9527
3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646
4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309
4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751
540 Lincoln Park Blvd
Suite 200
Dayton, OH 45429-6403
Phone (937) 298-8058
Hospital & facility affiliations
- Kettering Health Main Campus
- Kettering Health Dayton
- Kettering Health Miamisburg
- Soin Medical Center
- Kettering Health Troy
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.34 of 100
- Quality
- 63.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.14
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.0028780 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettering Independent Medical Group Inc | Current | Accepting new patients |
Locations
540 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (937) 293-1117
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
- General Acute Care Hospital
- Troy, OH
- NPI 1023587045
-
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
- General Acute Care Hospital
- Miamisburg, OH
- NPI 1316966518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1144893546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "654 TEALWOOD DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454301623",
"telephone_number": "413-531-0306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 LINCOLN PARK BLVD STE 200",
"city": "KETTERING",
"state": "OH",
"postal_code": "454296403",
"telephone_number": "937-298-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "ELIZABETH",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-22",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.0028780",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "egray634125@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "540 Lincoln Park Blvd Ste 200",
"city": "Kettering",
"state": "OH",
"country_code": "US",
"postal_code": "454296403",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
"affiliation": "N",
"address_1": "540 Lincoln Park Blvd Ste 200",
"city": "Kettering",
"state": "OH",
"country_code": "US",
"postal_code": "454296403",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.