Darrell S Gray Jr., DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4352 Issued in AR

Practice address

3016 W Main St Ste 200
Russellville, AR 72801-2453

Phone

(479) 967-9657

Fax

(479) 967-9658

NPI assigned

Aug 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346764172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W MAIN ST STE 200",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012453",
            "telephone_number": "479-967-9657",
            "fax_number": "479-967-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 W MAIN ST STE 200",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012453",
            "telephone_number": "479-967-9657",
            "fax_number": "479-967-9658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DARRELL",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Lorraine Gordon
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• Grace Counseling and Consulting
• Grace Counseling, Inc.
• Maureen Grace
• Robert Van Graybill, DDS
• Shawna Dee Grayham, STATE LICENSE
• Nicole Greathouse
• Brianna Green, LAC
• Kari Green, MHPP

• Physical Therapist in Russellville, AR
• Providers in Russellville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.