Kelly L Gray, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11572 Issued in AZ

Practice address

20414 N 27TH Ave
Phoenix, AZ 85027-3250

Phone

(888) 863-5898

NPI assigned

Feb 5, 2018

Last updated

Nov 7, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kelly.gray@75623782744068.direct.elationemr.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.

• Link Medical Inc

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1073031357
  Medicare reassignment NPD
• Tri-City Cardiology Consultants, PC

  • Cardiovascular Disease Physician
  • Mesa, AZ
  • NPI 1144288416
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ

  Medicare reassignment NPD
• Link Medical Inc

  dba Billet Medical

  • Internal Medicine Physician
  • Bullhead City, AZ
  • NPI 1730657016
  NPD
• Tri-City Cardiology Consultants, PC

  • Cardiac Rehabilitation Registered Nurse
  • Mesa, AZ
  • NPI 1689417636
  NPD

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1467951491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4395 E BRANDED CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979520",
            "telephone_number": "216-401-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20414 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273250",
            "telephone_number": "888-863-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11572",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN155353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Nicole Gray, ATC
• Heather Gray, COTA/L
• Jennifer Anne Gray, PHD
• Jessica Gray, L.AC. DAC, MSAC
• Karen Gray
• Kendra Gray, DO
• Kendrick Doron Gray, D.D.S.
• Kim Eileen Gray, RN
• Kimberly Gray
• Laraedo Gray

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.