Individual provider Active NPI

Gray McKay Buchanan

  • Clinical Child & Adolescent Psychologist
  • Greenwood, SC
National Provider Identifier
1386808178
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1108 Issued in SC
Practice address
155 Academy Ave
Greenwood, SC 29646-3869
Phone
(864) 725-4865
Fax
(864) 725-4883
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PST00096 RI
Clinical Child & Adolescent Psychologist 103TC2200X 1108 SC Primary

Addresses

Primary practice location

155 Academy Ave
Greenwood, SC 29646-3869

Mailing address

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gbuchanan127895@selfregional.direct-ci.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000567 SC Practitioner - Clinical Psychologist 6507921343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

115 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-7272

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PST00096RIMDClinical Child & Adolescent Psychologist
1108SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare CurrentSince Oct 17, 2011 Accepting new patients
Greenville Health System Past Accepting new patients

Locations

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1386808178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-4865",
            "fax_number": "864-725-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-4865",
            "fax_number": "864-725-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "GRAY",
        "middle_name": "MCKAY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "RI",
            "license": "PST00096",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "SC",
            "license": "1108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbuchanan127895@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "155 Academy Ave",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.