Sean Cornelius Gray

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011123 Issued in VA

Practice address

1727 King St Ste 105
Alexandria, VA 22314-2700

Phone

(703) 831-7872

NPI assigned

Aug 22, 2019

Sex

Male

Sole proprietor

Yes

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

Enrolled in DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Director of Finance-County of Fairfax VAGroup PAC ID 9739136847, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fairfax County, Virginia

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244

  DC, Single Specialty

  Medicare reassignment Care Compare group NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  Clinical, DC, VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1346897576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 NORTHGATE SQ UNIT 22",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905703",
            "telephone_number": "703-407-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 KING ST STE 105",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142700",
            "telephone_number": "703-831-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SEAN",
        "middle_name": "CORNELIUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Lanell Gray, D.O.
• Emily Gray
• Erica Michele Gray
• Katherine Kelly Gray
• Melina Ariel Gray
• Shavonne Gray, MS, LPC
• Valla V Grayeli, DMD
• Jane Grayson, MD
• Jeffrey L Graziano, DPM
• Greater Light Home Health Care LLC

• Clinical Social Worker in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.