Individual provider Active NPI

Shannon Gray, RN

  • Registered Nurse
  • Midlothian, VA
National Provider Identifier
1174299812
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001280810 Issued in VA
Practice address
2110 Abberly Cir Apt 4304
Midlothian, VA 23114-3272
Phone
(804) 317-1122
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001280810 VA Primary

Addresses

Primary practice location

2110 Abberly Cir Apt 4304
Midlothian, VA 23114-3272

Mailing address

2110 Abberly Cir Apt 4304
Midlothian, VA 23114-3272
Phone (804) 317-1122

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001280810VAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1174299812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 ABBERLY CIR APT 4304",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143272",
            "telephone_number": "804-317-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 ABBERLY CIR APT 4304",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143272",
            "telephone_number": "804-317-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHANNON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001280810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.