Angelica Nicole Gray, B.C.B.A.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-11-8855 Issued in IN

Practice address

8650 Commerce Park PL Ste A1
Indianapolis, IN 46268-3174

Phone

(317) 388-8131

NPI assigned

Jul 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1316225014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 COMMERCE PARK PL STE A1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683174",
            "telephone_number": "317-388-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 COMMERCE PARK PL STE A1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683174",
            "telephone_number": "317-388-8131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6051 Medora Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462281397",
            "country_code": "US",
            "telephone_number": "317-292-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANGELICA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "B.C.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-11-8855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201377280A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angelica@tiiba.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "angelica@tiiba.org",
            "address_1": "8650 Commerce Park Pl Ste A1",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462683174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Alicia J Gray, M.A.
• Amanda G Gray
• Austin R Gray, OT
• Benjamin Gray
• Brandon James Gray
• Brian Wallace Gray, MD
• Brittany Michelle Gray, LCSW

• Behavior Analyst in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.