Jack Gibson Gray, D.O.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

072904 Issued in GA

Practice address

135 Tamerlane
Peachtree City, GA 30269-2700

Phone

(404) 771-4665

NPI assigned

Jun 23, 2009

Last updated

Aug 4, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  NPD (past)
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  NPD (past)
• Wellstar Spalding Regional Hospital, Inc

  dba WellStar Spalding Regional Hospital

  • General Acute Care Hospital
  • Griffin, GA
  • NPI 1972535318
  NPD (past)

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1225266745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 TAMERLANE",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692700",
            "telephone_number": "404-771-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 TAMERLANE",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692700",
            "telephone_number": "404-771-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JACK",
        "middle_name": "GIBSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "072904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Harbour, Inc.
• Bridget Grady
• Sharon R Grant, LPC
• Brittani Marie Gray, LPC
• Hannah Gray, RPH
• Karen Greene, M.D.
• Lorene Greene, APN
• Miranda Greenfield, PA-C
• Cassandra Greer
• Haley Augusta Gresham, MS, LMFT

• Neonatal-Perinatal Medicine Physician in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Neonatal-Perinatal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.