Individual provider Active NPI

Ahsia Ke'Amber Gray, RN

  • Community Health Registered Nurse
  • Quincy, FL
National Provider Identifier
1255833539
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN9458344 Issued in FL
Practice address
278 Lasalle Lefall Dr
Quincy, FL 32351-5324
Phone
(850) 875-7200
NPI assigned
Mar 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN9458344 FL Primary

Addresses

Primary practice location

278 Lasalle Lefall Dr
Quincy, FL 32351-5324

Mailing address

278 Lasalle Lefall Dr
Quincy, FL 32351-5324

Other identifiers 1

IdentifierTypeStateIssuer
1346446895MedicaidFL

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9458344FLMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1255833539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 LASALLE LEFALL DR",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323515324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 LASALLE LEFALL DR",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323515324",
            "telephone_number": "850-875-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "AHSIA",
        "middle_name": "KE'AMBER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "FL",
            "license": "RN9458344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346446895",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; 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.