Individual provider Active NPI

Michelle Gray, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1336735240
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1032120 Issued in TX
Practice address
2520 Broadway St Ste 100
San Antonio, TX 78215-1148
Phone
(210) 595-1019
NPI assigned
Dec 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 767068 TX
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1032120 TX Primary

Addresses

Primary practice location

2520 Broadway St Ste 100
San Antonio, TX 78215-1148

Mailing address

2520 Broadway St Ste 100
San Antonio, TX 78215-1148
Phone (210) 595-1019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220825000141 TX Practitioner - Nurse Practitioner 7810371838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
767068TXMDRegistered Nurse
1032120TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. Single Specialty Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Bernice Gonzalez, MD, PA Single Specialty CurrentSince Jun 1, 2022 Accepting new patients
Texas Healthnet Medical Clinic LTD. Single Specialty PastSince Nov 1, 2021 Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

2520 Broadway St
Ste 100
San Antonio, TX 78215
Phone (210) 595-1019

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12437/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1336735240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 BROADWAY ST STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151148",
            "telephone_number": "210-595-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 BROADWAY ST STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151148",
            "telephone_number": "210-595-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "767068",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1032120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.