Individual provider Active NPI

Jessica Lynn Gray, CNP

  • Family Nurse Practitioner
  • East Boston, MA
National Provider Identifier
1316440506
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2262233 Issued in MA
Practice address
10 Gove St
East Boston, MA 02128-1920
Phone
(617) 569-5800
Fax
(617) 568-4780
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2262233 MA Primary

Addresses

Primary practice location

10 Gove St
East Boston, MA 02128-1920

Mailing address

10 Gove St
East Boston, MA 02128-1920
Phone (617) 568-4872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20180504001844 MA Practitioner - Nurse Practitioner 7113281833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Community Health Connections, IncGroup PAC ID 8729074992, shared by 5 NPIs, 91 clinicians

Practice addresses (Care Compare)

175 Connors St
Gardner, MA 01440-2637
Phone (978) 410-6100

326 Nichols Rd
Fitchburg, MA 01420-1914
Phone (978) 878-8100

529 Timpany Blvd
Gardner, MA 01440-3451
Phone (978) 878-8100

Hospital & facility affiliations

  • Heywood Hospital - Hospital, Gardner, MA, CCN 220095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2262233MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhealth Corporation CurrentSince Apr 23, 2018 Accepting new patients
Community Health Connections, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Apr 23, 2018 Accepting new patients
Community Health Connections, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Community Health Connections, Inc. Past Accepting new patients

Locations

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

326 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5270

130 Water St
Ste 4
Fitchburg, MA 01420
Phone (978) 868-9944

175 Connors St
Gardner, MA 01440
Phone (978) 410-6100

14 Manning Ave
Leominster, MA 01453
Phone (978) 847-0110

165 Mill St
Leominster, MA 01453
Phone (978) 466-3208

Interoperability endpoints

  • Direct secure messaging: jessica.gray.p1@direct.chcfhc.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1316440506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-568-4872",
            "fax_number": "617-568-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2262233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Boston, MA

Sources for this page

Verify at the official NPI Registry.