Individual provider Active NPI

Maggie Ann Gray, FNP-C

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1174349757
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024042771 Issued in MO
Practice address
2055 S Fremont Ave
Springfield, MO 65804-2206
Phone
(417) 820-4673
NPI assigned
Nov 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2024042771 MO Primary

Addresses

Primary practice location

2055 S Fremont Ave
Springfield, MO 65804-2206

Mailing address

1903 S 11TH Ave
Ozark, MO 65721-8842
Phone (479) 530-4318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113002157 MO Practitioner - Nurse Practitioner 7113455569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2115 S Fremont Ave
1100 MC Womens Oncology Whiteside
Springfield, MO 65804-2239
Phone (417) 820-3554

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jan 6, 2025 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Jan 6, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 6, 2025 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 1100
Springfield, MO 65804
Phone (417) 820-3554

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2115 S Fremont Ave
Springfield, MO 65804
Phone (417) 820-3912

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2055 S Fremont Ave
Springfield, MO 65804
Phone (417) 820-2468

Organizations & group practices 4

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 11

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": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1174349757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 S 11TH AVE",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657218842",
            "telephone_number": "479-530-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MAGGIE",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024042771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.