Individual provider Active NPI

Donald R Gray, DC

  • Chiropractor
  • Fairfield, CA
National Provider Identifier
1215047790
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
21701 Issued in CA
Practice address
2801 Waterman Blvd
Ste. 260
Fairfield, CA 94534-2987
Phone
(707) 427-1222
Fax
(707) 427-0663
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 21701 CA Primary

Addresses

Primary practice location

2801 Waterman Blvd
Ste. 260
Fairfield, CA 94534-2987

Mailing address

2801 Waterman Blvd
Ste. 260
Fairfield, CA 94534-2987
Phone (707) 427-1222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130128000328 CA Practitioner - Chiropractic 7810141892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gary E Bocci Chiropractic, IncGroup PAC ID 9335379072, 2 clinicians

Practice addresses (Care Compare)

2801 Waterman Blvd
Suite 260
Fairfield, CA 94534-2987
Phone (707) 427-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gary E Bocci Chiropractic, Inc Chiropractor CurrentSince Feb 9, 2014 Accepting new patients

Locations

2801 Waterman Blvd
Ste 260
Fairfield, CA 94534
Phone (707) 427-1222

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215047790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 WATERMAN BLVD",
            "address_2": "STE. 260",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945342987",
            "telephone_number": "707-427-1222",
            "fax_number": "707-427-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 WATERMAN BLVD",
            "address_2": "STE. 260",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945342987",
            "telephone_number": "707-427-1222",
            "fax_number": "707-427-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DONALD",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.