Individual provider Active NPI

Makena Gray, AUD

  • Audiologist
  • Thousand Oaks, CA
National Provider Identifier
1477374601
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU3919 Issued in CA
Practice address
301 S Moorpark Rd
Thousand Oaks, CA 91361-1008
Phone
(805) 379-0824
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X AU3919 CA Primary

Addresses

Primary practice location

301 S Moorpark Rd
Thousand Oaks, CA 91361-1008

Mailing address

69 W Twisted Oak Dr
Simi Valley, CA 93065-8241
Phone (805) 863-8657

Other practice location 1

1700 N Rose Ave
Oxnard, CA 93030-3790
Phone (805) 983-4214

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

State licenses

LicenseStateTypeSpecialty
AU3919CAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1477374601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 W TWISTED OAK DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930658241",
            "telephone_number": "805-863-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MOORPARK RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611008",
            "telephone_number": "805-379-0824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 N Rose Ave",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930303790",
            "country_code": "US",
            "telephone_number": "805-983-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MAKENA",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU3919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.