NPIMap

Individual provider Active NPI

Vanessa Gray

  • Student in an Organized Health Care Education/Training Program
  • Tampa, FL
National Provider Identifier
1154919645
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12901 Bruce B Downs Blvd # 5
Tampa, FL 33612-4799
Phone
(813) 974-8926
NPI assigned
Jan 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

12901 Bruce B Downs Blvd # 5
Tampa, FL 33612-4799

Mailing address

12901 Bruce B Downs Blvd # 5
Tampa, FL 33612-4742

Other practice location 1

12901 Bruce B Downs Blvd # 5
Tampa, FL 33612-4799
Phone (813) 974-8926

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809000593 FL Practitioner - Physician Assistant 4385006360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Urology Partners LLPGroup PAC ID 2062574924, 66 clinicians

Practice addresses (Care Compare)

1142 Bell Shoals Rd
Brandon, FL 33511-8909
Phone (813) 685-0827

12408 N 56TH St
Suite 1
Temple Terrace, FL 33617-1522
Phone (813) 980-3104

16513 S US Hwy 301
Wimauma, FL 33598-2032
Phone (813) 634-9231

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259
  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132
  • Adventhealth Riverview Hospital, Riverview, FL, CCN 100364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Tampa General Provider Network Inc PastSince Jun 1, 2022 Accepting new patients
Tampa General Provider Network Inc PastSince Jun 1, 2022 Accepting new patients
Florida Urology Partners LLP PastSince Nov 17, 2019 Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: vgray209530@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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 5

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": "1610150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1154919645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 5",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 5",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124799",
            "telephone_number": "813-974-8926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 Bruce B Downs Blvd # 5",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124799",
            "country_code": "US",
            "telephone_number": "813-974-8926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "VANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-09",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.