Gary G Gray, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

Practice address

2490 N Water St
Suite 16
Decatur, IL 62526-4251

Phone

(217) 875-4646

Fax

(217) 875-2870

NPI assigned

Nov 9, 2006

Last updated

Nov 20, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1979

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1275603672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 N WATER ST",
            "address_2": "SUITE 16",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264251",
            "telephone_number": "217-875-4646",
            "fax_number": "217-875-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 N WATER ST",
            "address_2": "SUITE 16",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264251",
            "telephone_number": "217-875-4646",
            "fax_number": "217-875-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "GARY",
        "middle_name": "G",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5884008",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6259G",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC ADMINISTAR",
            "identifier": "0159620001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBCS",
            "identifier": "4056086",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Graves
• Kadeeja Alivia Claudia Graves
• Cara A Gravlin, ACNP
• Ariana Gray, RBT
• Betelhem Gray
• Hannah Suzanne Gray, AU.D.
• Amber N Green
• Tarsheka Green, PMHNP-BC
• Teresa Green, LPN
• Gayla Greene

• Corneal and Contact Management Optometrist in Decatur, IL
• Providers in Decatur, IL by specialty
• Corneal and Contact Management Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.