Individual provider Active NPI

Justin James Gray, PSYD

  • Clinical Neuropsychologist
  • Roanoke, VA
National Provider Identifier
1518439397
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810006204 Issued in VA
Practice address
3 Riverside Cir
Roanoke, VA 24016-4955
Phone
(540) 526-1400
NPI assigned
Dec 18, 2018
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY.0004960 CO
Clinical Neuropsychologist 103G00000X 0810006204 VA Primary

Addresses

Primary practice location

3 Riverside Cir
Roanoke, VA 24016-4955

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

7624 Apple Grove Ln
Roanoke, VA 24018-5908
Phone (703) 508-1466

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgray117701@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20190820004159 VA Practitioner - Clinical Psychologist 4688902281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

1118 1St St SW
Roanoke, VA 24016-4702
Phone (540) 224-5170

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0004960COMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Aug 5, 2019 Accepting new patients
Carilion Medical Center CurrentSince Aug 5, 2019 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

3 Riverside Cir
Roanoke, VA 24016

Interoperability endpoints

  • Direct secure messaging: jgray117701@direct.carilionclinic.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1518439397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-526-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7624 Apple Grove Ln",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240185908",
            "country_code": "US",
            "telephone_number": "703-508-1466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-18",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "PSY.0004960",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810006204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgray117701@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "jgray117701@direct.carilionclinic.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3 Riverside Cir",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.