Individual provider Active NPI

Wendy M Gray, FNP

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1407458011
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0995930 Issued in CO
Practice address
1225 N Grand Ave
Pueblo, CO 81003-2845
Phone
(719) 544-5600
NPI assigned
Nov 10, 2020
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0995930 CO Primary

Addresses

Primary practice location

1225 N Grand Ave
Pueblo, CO 81003-2845

Mailing address

7631 Dellwood LN
Fountain, CO 80817-8106
Phone (720) 277-7284

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220214001921 CO Practitioner - Nurse Practitioner 4587057682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mednow Clinics, IncGroup PAC ID 0042533242, 56 clinicians

Practice addresses (Care Compare)

2960 N Circle Dr
Suite 200
Colorado Springs, CO 80909-1163
Phone (719) 634-8891

Merit-based Incentive Payment System (MIPS)

Final score
90.81 of 100Reported as apm
Quality
87.75
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0995930COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mednow Clinics, Inc CurrentSince Aug 1, 2024 Accepting new patients
Mednow Clinics, Inc Family Medicine Past Accepting new patients

Locations

2960 N Circle Dr
Ste 200
Colorado Springs, CO 80909
Phone (719) 387-7900

2997 Broadmoor Valley Rd
Colorado Springs, CO 80906
Phone (719) 203-4723

15101 E Iliff Ave
Ste 140
Denver, CO 80014
Phone (303) 584-7850

Interoperability endpoints

  • Direct secure messaging: wendy.gray.1@14209.direct.athenahealth.com

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, 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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1407458011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7631 DELLWOOD LN",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808178106",
            "telephone_number": "720-277-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032845",
            "telephone_number": "719-544-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "WENDY",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0995930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.