Individual provider Active NPI

Paula J Gray, APRN CNS GNP

  • Gerontology Nurse Practitioner
  • Fort Sam Houston, TX
National Provider Identifier
1548420375
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
569745 Issued in TX
Practice address
2410 Stanley Rd
Attn McHe Dha
Fort Sam Houston, TX 78234-7529
Phone
(210) 313-1993
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 569745 TX Primary

Addresses

Primary practice location

2410 Stanley Rd
Attn McHe Dha
Fort Sam Houston, TX 78234-7529

Mailing address

2410 Stanley Rd
Attn McHe Dha Brooke Army Medical Center
Ft Sam Houston, TX 78234
Phone (210) 313-1993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
569745TXMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1548420375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 STANLEY RD",
            "address_2": "ATTN MCHE DHA BROOKE ARMY MEDICAL CENTER",
            "city": "FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-313-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 STANLEY RD",
            "address_2": "ATTN MCHE DHA",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347529",
            "telephone_number": "210-313-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "PAULA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "APRN CNS GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "569745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.