Individual provider Active NPI

Tammy Lynn Gray, OTR/L

  • Occupational Therapist
  • Alamogordo, NM
National Provider Identifier
1366684516
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2333 Issued in NM
Practice address
1401 10TH St
Alamogordo, NM 88310-5012
Phone
(575) 437-3351
NPI assigned
Apr 2, 2009
Last updated
Apr 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2333 NM Primary

Addresses

Primary practice location

1401 10TH St
Alamogordo, NM 88310-5012

Mailing address

PO Box 2860
Alamogordo, NM 88311-2860
Phone (575) 437-3351

Other identifiers 2

IdentifierTypeStateIssuer
326563OtherNMMEDICARE
65608739MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151015000597 KS Practitioner - Occupational Therapist in Private Practice 4284782400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

101 W 151St St
Olathe, KS 66061-5348
Phone 91379100201018

1859 N Webb Rd
Wichita, KS 67206-3413
Phone (636) 422-1447

2300 N Tyler Rd
Wichita, KS 67205-8766
Phone (316) 260-6161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2333NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Apr 1, 2020 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Apr 1, 2020 Accepting new patients
Alamogordo Physical Therapy & Wellness Center, Inc Occupational Therapist Past Accepting new patients

Locations

6921 W 81st St
Overland Park, KS 66204
Phone (913) 901-8500

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1366684516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2860",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883112860",
            "telephone_number": "575-437-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 10TH ST",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883105012",
            "telephone_number": "575-437-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "2333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "326563",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65608739",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.