Individual provider Active NPI

Robert D. Gray, D.C.

  • Chiropractor
  • Perry, GA
National Provider Identifier
1174905244
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009442 Issued in GA
Practice address
1207 Main Street Suite C
Perry, GA 31069
Phone
(478) 987-9666
Fax
(478) 988-8091
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009442 GA Primary

Addresses

Primary practice location

1207 Main Street Suite C
Perry, GA 31069

Mailing address

P.O. Box 628
Perry, GA 31069
Phone (478) 987-9666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924001525 GA Practitioner - Chiropractic 8921316944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perry Chiropractic of Warner Robins, LLCGroup PAC ID 7719319375, 3 clinicians

Practice addresses (Care Compare)

4027 Watson Blvd
Suite 180
Warner Robins, GA 31093-9524
Phone (478) 333-1773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009442GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Perry Chiropractic of Warner Robins, LLC Chiropractor CurrentSince Apr 1, 2022 Accepting new patients
Dr. Brian Gillis P C Chiropractor CurrentSince Aug 10, 2015 Accepting new patients

Locations

1207 Main St
Ste C
Perry, GA 31069
Phone (478) 987-9666

4027 Watson Blvd
Ste 180
Warner Robins, GA 31093
Phone (478) 333-1773

Interoperability endpoints

  • Direct secure messaging: rgray@dbgp0001.direct.chirotouch.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1174905244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 628",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "31069",
            "telephone_number": "478-987-9666",
            "fax_number": "478-988-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MAIN STREET SUITE C",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "31069",
            "telephone_number": "478-987-9666",
            "fax_number": "478-988-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROBERT",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.