Individual provider Active NPI

Victoria Lynn Gray, FNP-C

  • Family Medicine Physician
  • Groton, MA
National Provider Identifier
1245939933
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RN2365451 Issued in MA
Practice address
788 Boston Rd
Groton, MA 01450-2056
Phone
(978) 449-0282
NPI assigned
Mar 1, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2365451 MA
Family Medicine Physician 207Q00000X RN2365451 MA Primary

Addresses

Primary practice location

788 Boston Rd
Groton, MA 01450-2056

Mailing address

788 Boston Rd
Groton, MA 01450-2056
Phone (978) 449-0282

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240220004608 MA Practitioner - Nurse Practitioner 1456701697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Practice addresses (Care Compare)

788 Boston Rd
Groton, MA 01450-2056
Phone (978) 449-0282

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2365451MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Medical of Massachusetts, PC Family Medicine CurrentSince Oct 30, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Jan 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

200 Groton Rd
Ayer, MA 01432
Phone (978) 784-9000

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

788 Boston Rd
Groton, MA 01450
Phone (978) 449-0282

9 Galen St
Ste 155
Watertown, MA 02472
Phone (857) 304-2444

Interoperability endpoints

  • Direct secure messaging: victoria.gray.1@32866.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1245939933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 BOSTON RD",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014502056",
            "telephone_number": "978-449-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 BOSTON RD",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014502056",
            "telephone_number": "978-449-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "VICTORIA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-09-26",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2365451",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "RN2365451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, MA

Sources for this page

Verify at the official NPI Registry.