Individual provider Active NPI

Evie Gray, CNP

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1336869437
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0030580 Issued in OH
Practice address
2940 N McCord Rd
Toledo, OH 43615-1753
Phone
(419) 842-3000
Fax
(419) 291-9883
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704395891 MI
Family Nurse Practitioner 363LF0000X APRN.CNP.0030580 OH Primary

Addresses

Primary practice location

2940 N McCord Rd
Toledo, OH 43615-1753

Mailing address

3422 Indian Rd
Ottawa Hills, OH 43606-2420
Phone (419) 704-2089

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address egray18359@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221203000522 MI Practitioner - Nurse Practitioner 9133598774 Reassigns benefits to 1 organization
I20221207001188 OH Practitioner - Nurse Practitioner 9133598774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Northwest Ohio Cardiology Consultants LLCGroup PAC ID 4981752938, 84 clinicians

Practice addresses (Care Compare)

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

718 N Macomb St
Mercy Memorial Hosp
Monroe, MI 49161-7815
Phone (734) 240-4557

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704395891MIMDFamily Nurse Practitioner
APRN.CNP.0030580OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Northwest Ohio Cardiology Consultants, LLC CurrentSince Nov 1, 2022 Accepting new patients
Promedica Northwest Ohio Cardiology Consultants, LLC CurrentSince Nov 1, 2022 Accepting new patients
The Toledo Hospital CurrentSince Nov 1, 2022 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
The Toledo Hospital CurrentSince Nov 1, 2022 Accepting new patients

Locations

770 Riverside Ave
Ste 106
Adrian, MI 49221
Phone (517) 266-0525

730 N Macomb St
Ste 429
Monroe, MI 48162
Phone (313) 242-7060

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

2940 N McCord Rd
Toledo, OH 43615
Phone (419) 842-3000

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

4041 W Sylvania Ave
Ste 204
Toledo, OH 43623
Phone (419) 725-3300

725 S Shoop Ave
Ste G101
Wauseon, OH 43567

Interoperability endpoints

  • Direct secure messaging: egray18359@direct.promedica.org

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 7

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1336869437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 INDIAN RD",
            "city": "OTTAWA HILLS",
            "state": "OH",
            "postal_code": "436062420",
            "telephone_number": "419-704-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-291-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "EVIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-11-03",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704395891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0030580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egray18359@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.