Dominiquekal Brown Gray, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AC003096 Issued in MD

Practice address

8032C Liberty Rd
Frederick, MD 21701-3239

Phone

(301) 846-0090

NPI assigned

Jul 19, 2019

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: dominiquekal.gray@398008301912068.direct.elationemr.com

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1306499264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8032C LIBERTY RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217013239",
            "telephone_number": "301-846-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8032C LIBERTY RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217013239",
            "telephone_number": "301-846-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DOMINIQUEKAL",
        "middle_name": "BROWN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903216",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC003096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Noelle Granata, CF-SLP
• Shawn Kay Grandia, M.D.
• Xavier Grant-Stovall, DC
• Candice Grant, LABA
• Grateful Therapeutics
• Leslie Ellen Gray, OCCUPATIONAL THERAPY
• Great Care, LLC
• Green Ridge Behavioral Health, LLC
• Green Valley Therapy, L.L.C.
• Cynthia Ann Green, LCPC

• All providers in Frederick, MD
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.