Shelley Gray, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AC003800 Issued in MD

Practice address

2080 Child St
Jacksonville, FL 32214-6122

Phone

(843) 228-5175

NPI assigned

Sep 5, 2018

Last updated

Jul 31, 2024By 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 3

Addresses

Other names 1

• Shelley Gray Other name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1275015257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "843-228-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322146122",
            "telephone_number": "843-228-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHELLEY",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC003800",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "198783",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "GRAY",
            "credential": "DNP, FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Juan A Gray, MSW
• Kathleen E Gray, ARNP
• Monica Gray
• Noel W Gray, DC
• Shawn Ryan Gray, LCSW
• Tameka Gray
• Kory Graybeal, RD
• Aliyah Ann Graybill
• Bianca I Grayer, COTA-L
• Barika Grayson, LMHC, NCC, CCM

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.