Individual provider Active NPI

Alyssa Marie Gray, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1346730959
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.022812 Issued in OH
Practice address
6001 E Broad St
Columbus, OH 43213-1502
Phone
(614) 234-6000
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN.413215 OH
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.022812 OH Primary

Addresses

Primary practice location

6001 E Broad St
Columbus, OH 43213-1502

Mailing address

2673 Kingston Ave
Grove City, OH 43123-3325
Phone (614) 361-9057

Other practice location 1

793 W State St
Columbus, OH 43222
Phone (614) 234-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180629002045 OH Practitioner - Nurse Practitioner 8123374303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Carmel Health SystemGroup PAC ID 6709793367, 84 clinicians

Practice addresses (Care Compare)

477 Cooper Rd
Suite 300
Westerville, OH 43081-8057
Phone (614) 898-8808

6001 E Broad St
Columbus, OH 43213-1502
Phone (614) 234-6000

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

Merit-based Incentive Payment System (MIPS)

Final score
94.28 of 100Reported as group
Quality
99.21
Improvement activities
40
Cost
62.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.413215OHMDCritical Care Medicine Registered Nurse
APRN.CNP.022812OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Health System CurrentSince Jun 10, 2018 Accepting new patients
Mount Carmel Health System CurrentSince Jun 10, 2018 Accepting new patients
Premier Health Specialists Inc CurrentSince Jul 5, 2021 Accepting new patients
Premier Health Specialists Inc CurrentSince Jul 5, 2021 Accepting new patients

Locations

2350 Miami Valley Dr
Ste 300
Centerville, OH 45459
Phone (937) 438-8640

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808

Interoperability endpoints

  • Direct secure messaging: agray1147993@direct.trinity-health.org

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.

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": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1346730959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 KINGSTON AVE",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233325",
            "telephone_number": "614-361-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131502",
            "telephone_number": "614-234-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "793 W State St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43222",
            "country_code": "US",
            "telephone_number": "614-234-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN.413215",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.022812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.