NPIMap

Individual provider Active NPI

Katey Gray, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1194249664
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0005072 Issued in CO
Practice address
1 Doctors Dr
Greenville, SC 29605-4266
Phone
(864) 572-7001
Fax
(864) 412-0436
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0005072 CO Primary

Addresses

Primary practice location

1 Doctors Dr
Greenville, SC 29605-4266

Mailing address

1 Doctors Dr
Greenville, SC 29605-4266
Phone (864) 572-7001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170925001611 CO Practitioner - Physician Assistant 8628342045 Reassigns benefits to 1 organization
I20210324002852 SC Practitioner - Physician Assistant 8628342045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4601 S Mason St
Fort Collins, CO 80525-3740
Phone (970) 266-3600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Feb 26, 2023 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 25, 2025 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Feb 26, 2023 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4601 S Mason St
Fort Collins, CO 80525
Phone (970) 266-3600

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1194249664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054266",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054266",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KATEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0005072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.