Charles Gravely, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA02247 Issued in TX

Practice address

11910 Greenville Ave
Suite 500
Dallas, TX 75243-3596

Phone

(214) 572-1124

Fax

(214) 572-7724

NPI assigned

Feb 12, 2008

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

Physician Assistant

Practice roles

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.

• Citimed, P.a.

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1487823316
  NPD (past)
• Primacare Medical Centers

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1104905728
  NPD (past)
• Emergency Medical Associates of New Jersey PA

  • Emergency Medicine Physician
  • Long Branch, NJ
  • NPI 1841456068
  NPD (past)

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1235307307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELY",
        "first_name": "CHARLES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grateful Heart Medical Services PLLC
• Gratitude House
• Rachel K Gratz, PA
• Cynthia Ann Graul, NP C
• Roger Dickinson Graulty, CRNA
• Annah Graves
• Ashley Graves
• Gregory Keith Graves
• Holden T Graves, PHARMD
• Joilavia Graves

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.