Individual provider Active NPI

Matthew Patrick Gray, PT

  • Physical Therapist
  • Vail, CO
National Provider Identifier
1255527305
Registry record updated Sep 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL-938 Issued in CO
Practice address
894 Spruce CT
Vail, CO 81657-4455
Phone
(720) 323-0698
NPI assigned
Sep 22, 2007
Last updated
Sep 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL-938 CO Primary

Addresses

Primary practice location

894 Spruce CT
Vail, CO 81657-4455

Mailing address

894 Spruce CT
Vail, CO 81657-4455
Phone (720) 323-0698

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTL-938COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190419200000",
    "number": "1255527305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 SPRUCE CT",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816574455",
            "telephone_number": "720-323-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 SPRUCE CT",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816574455",
            "telephone_number": "720-323-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MATTHEW",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-22",
        "last_updated": "2007-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL-938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2007; 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.