NPIMap

Individual provider Active NPI

Christopher Charles Gray, D.O.

  • Family Medicine Physician
  • Festus, MO
National Provider Identifier
1437306297
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008018601 Issued in MO
Practice address
1471 US Highway 61
Festus, MO 63028-4109
Phone
(636) 937-2700
NPI assigned
Aug 24, 2008
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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 2008018601 MO Primary

Addresses

Primary practice location

1471 US Highway 61
Festus, MO 63028-4109

Mailing address

1471 US Highway 61
Festus, MO 63028-4109
Phone (636) 937-2700

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090601000270 MO Practitioner - Family Practice 7911056551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1471 US Hwy 61
Festus, MO 63028-4109
Phone (636) 937-2700

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

4438 Telegraph Rd
Saint Louis, MO 63129-3316
Phone (314) 953-8250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008018601MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Family Medicine CurrentSince Sep 21, 2019 Accepting new patients
Physician Groups LC CurrentSince Sep 21, 2019 Accepting new patients

Locations

1471 US Highway 61
Crystal Cty, MO 63028
Phone (636) 937-2700

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

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 8

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": "1219536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1437306297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284109",
            "telephone_number": "636-937-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284109",
            "telephone_number": "636-937-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-24",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008018601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1471 US Highway 61",
            "city": "Festus",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630284109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.