Individual provider Active NPI

Michelle L Gray, FNP APRN-BC

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1548403629
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138667 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104
Phone
(682) 855-4000
NPI assigned
Apr 20, 2009
Last updated
Apr 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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 AP138667 TX Primary
Independent Duty Medical Technicians 1710I1003X NU

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104

Mailing address

2700 Doolittle Dr
Ellsworth AFB, SD 57706-4854
Phone (605) 385-3331

Other practice location 1

2700 Doolittle Dr
Ellsworth AFB, SD 57706-4854
Phone (605) 385-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220803001980 TX Practitioner - Nurse Practitioner 0244612547 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jun 21, 2022 Accepting new patients
Vpa of Texas PLLC CurrentSince Jun 21, 2022 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jun 21, 2022 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 4

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1548403629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 DOOLITTLE DR",
            "city": "ELLSWORTH AFB",
            "state": "SD",
            "postal_code": "577064854",
            "telephone_number": "605-385-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "682-855-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Doolittle Dr",
            "address_purpose": "LOCATION",
            "city": "Ellsworth AFB",
            "state": "SD",
            "postal_code": "577064854",
            "country_code": "US",
            "telephone_number": "605-385-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "FNP APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138667",
            "primary": true
        },
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.