Individual provider Active NPI

Jennifer Anne Gray, PHD

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1508167560
Registry record updated Apr 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4139 Issued in AZ
Practice address
240 W Thomas Rd # 400
Phoenix, AZ 85013-4407
Phone
(602) 406-6262
Fax
(602) 406-6261
NPI assigned
Nov 8, 2010
Last updated
Apr 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4139 AZ Primary
Clinical Child & Adolescent Psychologist 103TC2200X 4139 AZ

Addresses

Primary practice location

240 W Thomas Rd # 400
Phoenix, AZ 85013-4407

Mailing address

240 W Thomas Rd # 400
Phoenix, AZ 85013-4407
Phone (602) 406-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000407 AZ Practitioner - Clinical Psychologist 3577714153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

500 W Thomas Rd
680 DHMG St Joseph's Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
St Josephs Pathology Current Accepting new patients
St. Joseph's Outpatient Surgery Center, LLC Current Accepting new patients
Sjhmc Physician Services CurrentSince Apr 1, 2023 Accepting new patients
Dignity Health Past Accepting new patients

Locations

240 W Thomas Rd
#301
Phoenix, AZ 85013
Phone (602) 406-6262

240 W Thomas Rd
#400
Phoenix, AZ 85013
Phone (602) 406-6262

240 W Thomas Rd
Ste 400
Phoenix, AZ 85013
Phone (602) 406-6262

240 W Thomas Rd
Ste 401
Phoenix, AZ 85013
Phone (602) 406-6262

240 W Thomas Rd
Ste 404
Phoenix, AZ 85013

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

File 56765
Los Angeles, CA 90074

Organizations & group practices 5

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": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682121600000",
    "number": "1508167560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W THOMAS RD # 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134407",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W THOMAS RD # 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134407",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "4139",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "4139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.