Shameeka R Gray, FNP-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11017747 Issued in FL

Practice address

10013 Water Works LN
Riverview, FL 33578-5304

Phone

(813) 252-0171

Fax

(883) 941-2369

NPI assigned

Apr 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24851/brand/1/csg/1/fhir/r4

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.

• Honeysand Mental Health & Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
  • NPI 1922879139
  Medicare reassignment NPD Authorized official
• Brightside Health, Inc.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1073072658

  FL

  Medicare reassignment Care Compare group NPD
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Post Acute Specialists of Florida PLLC

  • Internal Medicine Physician
  • Bradenton, FL
  • NPI 1992571608

  Family

  Medicare reassignment NPD
• Prestige Health & Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valrico, FL
  • NPI 1811650831
  Medicare reassignment NPD
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482
  NPD (past)
• Southern Skin & Wellness Center

  • Family Medicine Physician
  • Valdosta, GA
  • NPI 1720224298
  NPD (past)

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1194388967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336128272",
            "telephone_number": "229-462-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10013 WATER WORKS LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785304",
            "telephone_number": "813-252-0171",
            "fax_number": "883-941-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHAMEEKA",
        "middle_name": "R",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11017747",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024186297",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN227455",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30130",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN227455",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186297",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11017747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Care Services LLC
• Grant Consulting Company
• Tammy Grant Williams, APRN
• Charlotte Selena Grant
• Vanessa Marie Grant
• Mellvva Green
• Emma Kitayne Greenbaum, MMS, PA-C
• Andrew K Greenfield, MD
• Lauryn Greenfield
• Dina Greenwell, PHARM D.

• Psychiatric/Mental Health Nurse Practitioner in Riverview, FL
• Providers in Riverview, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.