Robert Elliott Gray

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12250 Issued in NC

Practice address

1530 Union Rd Ste a
Gastonia, NC 28054-2201

Phone

(704) 867-6188

Fax

(704) 866-4437

NPI assigned

Dec 3, 2021

Sex

Male

Sole proprietor

Yes

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 NC

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychiatric Services of Carolinas, P.C.Group PAC ID 7315040458, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychiatric Services of Carolinas, P.C.

  • Specialist
  • Gastonia, NC
  • NPI 1710012174
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1285392464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 UNION RD",
            "address_2": "STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542201",
            "telephone_number": "704-867-6188",
            "fax_number": "704-866-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 UNION RD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542201",
            "telephone_number": "704-867-6188",
            "fax_number": "704-866-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROBERT",
        "middle_name": "ELLIOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-03",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Waugh Gray
• Kaffia Radiance Jennifer Gray
• Lisa C Gray
• Nicole Marie Gray, FNP-C
• Quetta Denise Gray
• Stephanie Lauren Gray, MD
• Dino A Graziano, M.D.
• Great Works Private Care LLC
• Greater Charlotte Oral & Facial Surgery
• Greater Developmental Achievements

• Physician Assistant in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2023; 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.