Keandra Chante Gray

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

37587336 Issued in TX

Practice address

1333 W Washington St
Stephenville, TX 76401-4168

Phone

(254) 986-9000

NPI assigned

Jan 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1376017699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 LIONS GATE LN",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495623",
            "telephone_number": "254-319-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764014168",
            "telephone_number": "254-986-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KEANDRA",
        "middle_name": "CHANTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "37587336",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "37587336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayci Mae Goolsby
• Gordon Counseling Center, Inc.
• Jordan Gossett
• Dennis Graham, D.O.
• Jordan Jane Graham
• Kristin Gray, COTA
• Tiffany Nicole Green, BS
• Angela Michelle Greer, OTR
• Cathy J Gregory, LCSW
• Kimberly Grose

• Student in an Organized Health Care Education/Training Program in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.