NPIMap

Individual provider Active NPI

Clark Anthony Gray, M.D.

  • Internal Medicine Physician
  • McCalla, AL
National Provider Identifier
1427141027
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00024898 Issued in AL
Practice address
22720 Bucksville Rd
McCalla, AL 35111
Phone
(205) 481-8640
NPI assigned
Oct 2, 2006
Last updated
Nov 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00024898 AL Primary

Addresses

Primary practice location

22720 Bucksville Rd
McCalla, AL 35111

Mailing address

PO Box 11407
Birmingham, AL 35246-0777
Phone (205) 481-7670

Other identifiers 4

IdentifierTypeStateIssuer
721608375OtherALMEDICARE COMPLETE
I32233OtherALSENIORS FIRST
009941477MedicaidAL
051539186OtherALBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000197 AL Practitioner - Internal Medicine 8527004134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Alabama College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

22720 Bucksville Rd
MC Calla, AL 35111-2711
Phone (205) 481-8640

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.67 of 100Reported as apm
Quality
80.18
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00024898ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical West Hospital Authority, an Affiliate of Uab Health System CurrentSince Jan 1, 2006 Accepting new patients
Medical West Hospital Authority, an Affiliate of Uab Health System Internal Medicine Current Accepting new patients

Locations

5000 Medical West Way
Bessemer, AL 35022
Phone (205) 481-7312

995 9th Ave SW
Bessemer, AL 35022
Phone (205) 481-7155

22720 Bucksville Rd
Mc Calla, AL 35111
Phone (205) 477-4105

Interoperability endpoints

  • Direct secure messaging: gray.clark@direct.uabmw.org

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.

Hospital & facility affiliations 7

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1427141027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460777",
            "telephone_number": "205-481-7670",
            "fax_number": "205-481-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22720 BUCKSVILLE RD",
            "city": "MCCALLA",
            "state": "AL",
            "postal_code": "35111",
            "telephone_number": "205-481-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CLARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00024898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE COMPLETE",
            "identifier": "721608375",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENIORS FIRST",
            "identifier": "I32233",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009941477",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051539186",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McCalla, AL

Sources for this page

Verify at the official NPI Registry.