Individual provider Active NPI

James A Gray, M.D.

  • Family Medicine Physician
  • Fayetteville, TN
National Provider Identifier
1497869259
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31859 Issued in TN
Practice address
108 Medical Center Blvd
Suite G-50
Fayetteville, TN 37334-2741
Phone
(931) 438-4111
Fax
(866) 258-0817
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31859 TN Primary

Addresses

Primary practice location

108 Medical Center Blvd
Suite G-50
Fayetteville, TN 37334-2741

Mailing address

108 Medical Center Blvd
# G50
Fayetteville, TN 37334-2741
Phone (931) 438-4111

Other identifiers 3

IdentifierTypeStateIssuer
89009847OtherALBCBS AL
3850808MedicaidTN
4015743OtherTNBCBS TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120321000512 TN Practitioner - Family Practice 1850551326 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31859TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Medical Group, PC Family Medicine CurrentSince Aug 15, 2001 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jamesgray@parkwaymg.allscriptsdirect.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1497869259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER BLVD",
            "address_2": "# G50",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342741",
            "telephone_number": "931-438-4111",
            "fax_number": "866-258-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER BLVD",
            "address_2": "SUITE G-50",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342741",
            "telephone_number": "931-438-4111",
            "fax_number": "866-258-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JAMES",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "31859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "89009847",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3850808",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4015743",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, TN

Sources for this page

Verify at the official NPI Registry.