Kimberly Gray, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

28212858A Issued in IN

Practice address

65 Airport Pkwy
Greenwood, IN 46143-1439

Phone

(317) 887-1348

NPI assigned

Jul 7, 2022

Last updated

Jul 7, 2022By the provider in NPPES

Sex

Female

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

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloomington Meadows GPGroup PAC ID 6002707494, 10 clinicians

Valle Vista LLCGroup PAC ID 8224948930, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bloomington Meadows GP

  • Family Nurse Practitioner
  • Bloomington, IN
  • NPI 1033298120
  Medicare reassignment Care Compare group NPD
• Valle Vista, LLC

  dba Valle Vista Health System

  • Psychiatric Hospital
  • Greenwood, IN
  • NPI 1699722405
  Medicare reassignment Care Compare group NPD
• Valle Vista LLC

  dba New Vista North

  • Methadone Clinic
  • Indianapolis, IN
  • NPI 1548036262
  NPD
• Valle Vista LLC

  dba Valle Vista Health System

  • Mental Health Counselor
  • Greenwood, IN
  • NPI 1336300359
  NPD (past)

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1265165229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2382 E WINDING BROOK CIR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474014382",
            "telephone_number": "812-327-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 AIRPORT PKWY",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431439",
            "telephone_number": "317-887-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KIMBERLY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28212858A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaci Graphman
• Brenda Graves-Croom
• Aireol Onyae Graves
• Talia Graves, RBT
• Christopher D Gray, PT
• Great Lakes Institute for Neuropsychology & Behavioral Health
• Green Counseling & Associates
• Angie Green, M.A.
• Brian Lee Green, D.C.
• Dana Green, RBT

• Psychiatric/Mental Health Nurse Practitioner in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.