Elisse Kenty Gray, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014353 Issued in CA

Practice address

116 Defense Hwy Ste 500
Annapolis, MD 21401-7063

Phone

(410) 266-1644

Fax

(443) 808-8551

NPI assigned

Mar 8, 2018

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

Other names 1

• Ms. Elisse Kenty Professional name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9065/brand/1/csg/1/fhir/r4
• Direct secure messaging: elisse.kenty.1@9065.direct.athenahealth.com

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.

• Annapolis Asthma Pulmonary and Sleep Spec

  • Pulmonary Disease Physician
  • Annapolis, MD
  • NPI 1306911995
  Medicare reassignment NPD

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1386147056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY STE 500",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017063",
            "telephone_number": "410-266-1644",
            "fax_number": "443-808-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY STE 500",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017063",
            "telephone_number": "410-266-1644",
            "fax_number": "443-808-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ELISSE",
        "middle_name": "KENTY",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R191357",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISSE",
            "last_name": "KENTY",
            "prefix": "MS.",
            "credential": "CRNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shawn A Graham, RBT
• Theresa J Grasing, P.A-C
• Cheyenne Graves
• Ashley Nicole Gray
• Dorcas Gray, LCSW-C,BCD
• Razhan Donyeh Grayson
• Peter R Graze, M.D.
• Christopher Emilio Graziano, MD
• Tammy Grazioli, LMSW
• Greater Maryland Pain Management, LLC

• Family Nurse Practitioner in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.