Active NPI
Tesa Nicole Grey, RN
- Registered Nurse
- Buckhannon, WV
National Provider Identifier
1427770700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 96731
- Practice address
- 21 E Main St Ste 302
Buckhannon, WV 26201-2910 - Phone
- (044) 736-8023
- NPI assigned
- Sep 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 96731 | WV | Primary |
Addresses
Primary practice location
21 E Main St Ste 302
Buckhannon, WV 26201-2910
Mailing address
5609 Possum Hollow Rd
Mill Creek, WV 26280-5155
Phone (304) 642-7624
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Desktop/Tablet |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96731 | WV | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1427770700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5609 POSSUM HOLLOW RD",
"city": "MILL CREEK",
"state": "WV",
"postal_code": "262805155",
"telephone_number": "304-642-7624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 E MAIN ST STE 302",
"city": "BUCKHANNON",
"state": "WV",
"postal_code": "262012910",
"telephone_number": "044-736-8023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREY",
"first_name": "TESA",
"middle_name": "NICOLE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WV",
"license": "96731",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Desktop/Tablet",
"affiliation": "N",
"address_1": "21 E Main St Ste 302",
"city": "Buckhannon",
"state": "WV",
"country_code": "US",
"postal_code": "262012910",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Buckhannon, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.