Active NPI
Scott W Gray, CRNA
- Certified Registered Nurse Anesthetist
- Edmonds, WA
National Provider Identifier
1255327755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP30000255
- Practice address
- 14820 72ND Ave W
Edmonds, WA 98026-4008 - Phone
- (425) 582-9421
- Fax
- (425) 967-7919
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | AP30000255 | WA | Primary |
Addresses
Primary practice location
14820 72ND Ave W
Edmonds, WA 98026-4008
Mailing address
14820 72ND Ave W
Edmonds, WA 98026-4008
Phone (425) 582-9421
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9603333 | Medicaid | WA | |
| P00137193 | Other | RAILROAD MEDICARE | |
| N23405 | Other | ID | IDAHO LICENSE |
| 000538000 | Medicaid | ID | |
| A3557 | Other | ID | BC ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Specialists of Albuquerque | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Albuquerque, NM
- NPI 1831104215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401321600000",
"number": "1255327755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14820 72ND AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980264008",
"telephone_number": "425-582-9421",
"fax_number": "425-967-7919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14820 72ND AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980264008",
"telephone_number": "425-582-9421",
"fax_number": "425-967-7919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "SCOTT",
"middle_name": "W",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2014-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP30000255",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9603333",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00137193",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO LICENSE",
"identifier": "N23405",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000538000",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC ID",
"identifier": "A3557",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.