Individual provider Active NPI

Rebecca Michelle Gray, APRN

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1497998041
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A003229 Issued in AR
Practice address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
Fax
(501) 526-5148
NPI assigned
Apr 13, 2009
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AO3229 AR
Family Nurse Practitioner 363LF0000X A003229 AR Primary

Addresses

Primary practice location

4301 W Markham St # 783
Little Rock, AR 72205-7101

Mailing address

2 Lucky LN
Morrilton, AR 72110-9147
Phone (501) 977-4812

Other practice location 1

201 Donaghey Ave
Conway, AR 72035-5001
Phone (501) 450-3136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20090702000313 AR Practitioner - Nurse Practitioner 2860543824 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A003229ARMDFamily Nurse Practitioner
AO3229ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Central Arkansas Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Mar 1, 2020 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Mar 1, 2020 Accepting new patients
University of Central Arkansas CurrentSince Jan 1, 2022 Accepting new patients
University of Central Arkansas Family PastSince Feb 13, 2022 Accepting new patients

Locations

201 Donaghey Ave
Conway, AR 72035
Phone (501) 450-3136

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1497998041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LUCKY LN",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721109147",
            "telephone_number": "501-977-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Donaghey Ave",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720355001",
            "country_code": "US",
            "telephone_number": "501-450-3136",
            "fax_number": "501-450-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "REBECCA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AO3229",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.