Melissa Marie Gray, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN257772 Issued in GA

Practice address

2160 Fountain Dr
Snellville, GA 30078-7022

Phone

(770) 979-0200

NPI assigned

Aug 3, 2018

Last updated

Jul 16, 2020By the provider in NPPES

Sex

Female

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

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: melissa.gray.1@8042.direct.athenahealth.com

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment Care Compare group NPD
• Creative Life Center, LLC

  • Geriatric Psychiatry Physician
  • Grayson, GA
  • NPI 1780227140
  NPD
• Esfahani Enterprises LLC

  dba Thriveworks

  • Counseling Psychologist
  • Woodstock, GA
  • NPI 1457901340
  NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1457839219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 EMA DELL PL",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525375",
            "telephone_number": "757-735-5682",
            "fax_number": "888-627-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 FOUNTAIN DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787022",
            "telephone_number": "770-979-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1637 Athens Hwy",
            "address_purpose": "LOCATION",
            "city": "Grayson",
            "state": "GA",
            "postal_code": "300171768",
            "country_code": "US",
            "telephone_number": "678-344-8268",
            "fax_number": "888-627-6444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2037 Ema Dell Pl",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300525375",
            "country_code": "US",
            "telephone_number": "757-735-5682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN257772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Scott Gravante, D.C.
• Patricia Theresa Gray-Smith, NURSE PRACTITIONER
• Geneva Marie Gray, PHD, LPC, NCC, CPCS
• Karen Nguyen Gray, PA-C
• Mark A. Gray, D.M.D.
• Tracy Lee Gray, LPC
• Grayson Family Care
• Greater Gwinnett Internal Medicine Associates LLC
• Greater Gwinnett Physician Practice Company (South Gwinnett Family Medicine)
• Greater Path Counseling

• Psychiatric/Mental Health Nurse Practitioner in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.