Ryan Nicholas Gray, BS, CDCA, QMHS

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Practice address

2775 State Route 39
Shelby, OH 44875-9466

Phone

(419) 747-3322

NPI assigned

Oct 17, 2017

Sex

Male

Sole proprietor

Yes

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

Credentials

Bachelor of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornell Abraxas Group, LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Shelby, OH
  • NPI 1376518902

  Substance Abuse Treatment, Children

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1447761580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "RYAN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "BS, CDCA, QMHS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Hall Gove
• Robin Graber
• Ja'Lisa Graham
• Christine Lynn Grassel, D.C.
• Natalie Graves
• Green Palms Health & Rehab Center of Shelby, LLC
• Caitlin Marie Green, CDCA
• Brandi Lee Gregory
• Cody Grice, QMHS
• Hanna Griffis

• Children's Substance Abuse Rehabilitation Facility in Shelby, OH
• Providers in Shelby, OH by specialty
• Children's Substance Abuse Rehabilitation Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.