Mary Helen Gray, R.N., N.P

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2006005436 Issued in MN

Practice address

5775 Wayzaya Blvd
Suite 190
St. Louis Park, MN 55416

Phone

(952) 738-4623

NPI assigned

Jun 3, 2006

Last updated

Aug 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1487692448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 190",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162627",
            "telephone_number": "952-738-4623",
            "fax_number": "952-738-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZAYA BLVD",
            "address_2": "SUITE 190",
            "city": "ST. LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-738-4623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 E 28th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071195",
            "country_code": "US",
            "telephone_number": "952-944-3472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MARY",
        "middle_name": "HELEN",
        "name_prefix": "Mrs.",
        "credential": "R.N., N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "2006005436",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 149240 0",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucreshia Grant, MS
• Shelly Grant, LICSW
• Steven Christopher Gravatt
• Kera L T Graves, OTR/L
• Jill Maven Gray, PSYD, LP
• Paul W Gray, CRNA
• Janet Grayson, MD
• Elliot Graziano
• Kristen Marie Graziano
• Pamela Grebel

• Adult Health Nurse Practitioner in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.