Derek Allen Gray, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.009402 Issued in IL

Practice address

2425 E 71St St
Chicago, IL 60649-2612

Phone

(773) 721-5000

NPI assigned

Jan 3, 2022

Sex

Male

Sole proprietor

No

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

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1396406237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S FINANCIAL PL APT 1703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051794",
            "telephone_number": "804-317-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 E 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492612",
            "telephone_number": "773-721-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DEREK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.009402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Gray, PT, DPT
• Chanel A Gray, LCPC
• Chantel Gray, LSW
• Clarice R Gray, CNA
• Courtney Gray
• Dominique Gray
• Erica Gray
• Jalisa Gray
• Jennifer Gray, LCPC, CADC
• Jocelyn L Gray, RN

• Physical Therapy Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.