Jack Kenneth Gray Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

15966 Issued in OK

Practice address

909 Alameda St
Norman, OK 73071-5229

Phone

(405) 573-3934

Fax

(405) 573-3962

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oklahoma Integrated Care PLCGroup PAC ID 5193113751, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jack.gray.1@30472.direct.athenahealth.com

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.

• Oklahoma Integrated Care PLC

  • Multi-Specialty Clinic/Center
  • Ardmore, OK
  • NPI 1316540495
  Medicare reassignment Care Compare group NPD
• Compass Health, Inc

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  NPD (past)
• Life Management Center of Northwest Florida Inc

  • Psychiatry Physician
  • Blountstown, FL
  • NPI 1659301877
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1295708519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 ALAMEDA ST",
            "address_2": "PO BOX 400",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715229",
            "telephone_number": "405-573-3934",
            "fax_number": "405-573-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 ALAMEDA ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715229",
            "telephone_number": "405-573-3934",
            "fax_number": "405-573-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JACK",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "19414",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "15966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa Grassmuck, RBT
• John Graven
• Mandy Graves, RDMS, FE
• Rebekah Graves
• Aaron Kyle Gray, D.C.
• Naomi Joy Gray
• Rachel Annalouise Gray, LPC-C
• Lily Grayson
• Mae Grayson, CLC
• Rachel Lee Grayson, PT

• Psychiatry Physician in Norman, OK
• Providers in Norman, OK by specialty
• Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.