Individual provider Active NPI

Zach James Gray, M.AC.O.M.,L.AC

  • Acupuncturist
  • Pueblo, CO
National Provider Identifier
1326218108
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1156 Issued in CO
Practice address
3312 Colfax Ave.
Pueblo, CO 81008
Phone
(719) 248-4820
NPI assigned
Mar 7, 2008
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1156 CO Primary

Addresses

Primary practice location

3312 Colfax Ave.
Pueblo, CO 81008

Mailing address

2701 N Elizabeth St
Pueblo, CO 81003-3643
Phone (719) 248-4820

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1156COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
White Crane Acupuncture CurrentSince Apr 17, 2022 Accepting new patients
White Crane Acupuncture LLC Acupuncturist Current Accepting new patients

Locations

2701 N Elizabeth St
Pueblo, CO 81003
Phone (719) 248-4820

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1326218108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N ELIZABETH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033643",
            "telephone_number": "719-248-4820",
            "fax_number": "719-299-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 COLFAX AVE.",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81008",
            "telephone_number": "719-248-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ZACH",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "M.AC.O.M.,L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-07",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "1156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.

Verify at the official NPI Registry.