Active NPI
David Bradley Gray, DO
- Family Medicine Physician
- Lewisburg, PA
National Provider Identifier
1326087172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS006646E
- Practice address
- 131 JPM Rd Ste a
Lewisburg, PA 17837-9309 - Phone
- (570) 523-6115
- Fax
- (570) 523-6178
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS006646E | PA | Primary |
Addresses
Primary practice location
131 JPM Rd Ste a
Lewisburg, PA 17837-9309
Mailing address
7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0011324990008 | Medicaid | PA | |
| 136447F6K | Other | PA | MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | BradleyGrayDO@fpc.medentdirect.com | Health Information Exchange (HIE) | FAMILY PRACTICE CENTER, PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS006646E | PA | MD | Family Medicine Physician |
Interoperability endpoints
- bradleygraydo@fpc.medentdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649980800000",
"number": "1326087172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 DOCK HILL RD",
"city": "MIDDLEBURG",
"state": "PA",
"postal_code": "178428910",
"telephone_number": "570-837-2123",
"fax_number": "570-837-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 JPM RD STE A",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178379309",
"telephone_number": "570-523-6115",
"fax_number": "570-523-6178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DAVID",
"middle_name": "BRADLEY",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2022-04-15",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OS006646E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0011324990008",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "136447F6K",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "BradleyGrayDO@fpc.medentdirect.com",
"affiliation": "Y",
"affiliationName": "FAMILY PRACTICE CENTER, PC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "131 Jpm Rd Ste A",
"city": "Lewisburg",
"state": "PA",
"country_code": "US",
"postal_code": "178379309",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lewisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.