Active NPI
Roycelyn Linette Gray, DMD
- Endodontics
- Louisville, KY
National Provider Identifier
1538276787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 6591
- Practice address
- 501 S Preston St RM 334
Louisville, KY 40202-1701 - Phone
- (502) 852-7212
- Fax
- (502) 852-1317
- NPI assigned
- Aug 24, 2006
- Last updated
- Aug 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 6591 | KY | Primary |
Addresses
Primary practice location
501 S Preston St RM 334
Louisville, KY 40202-1701
Mailing address
501 S Preston St RM 334
Louisville, KY 40202-1701
Phone (502) 852-7212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161004002712 | KY | Order and Referring Only - Other (Physician) | 9436447612 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6591 | KY | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565308800000",
"number": "1538276787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S PRESTON ST RM 334",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021701",
"telephone_number": "502-852-7212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S PRESTON ST RM 334",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021701",
"telephone_number": "502-852-7212",
"fax_number": "502-852-1317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "ROYCELYN",
"middle_name": "LINETTE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2019-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "KY",
"license": "6591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.