Individual provider Active NPI

Thelma Jean Gray, APRN

  • Family Nurse Practitioner
  • Barbourville, KY
National Provider Identifier
1548755499
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012785 Issued in KY
Practice address
185 Treuhaft Blvd Ste 4
Barbourville, KY 40906-4090
Phone
(606) 545-6766
NPI assigned
Jun 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3012785 KY Primary

Addresses

Primary practice location

185 Treuhaft Blvd Ste 4
Barbourville, KY 40906-4090

Mailing address

185 Treuhaft Blvd
Suite 4
Barbourville, KY 40906-6780
Phone (160) 654-5676

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402003357 KY Practitioner - Nurse Practitioner 4587093117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor of Hope Medical and Behavioral Health Care, LLCGroup PAC ID 2769811397, 2 clinicians

Practice addresses (Care Compare)

185 Treuhaft Blvd
Apt 4
Barbourville, KY 40906-8300
Phone (606) 545-6766

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Oct 3, 2023 Accepting new patients
Harbor of Hope Medical and Behavioral Health Care, LLC Family CurrentSince Dec 29, 2019 Accepting new patients
Harbor of Hope Medical and Behavioral Health Care, LLC PastSince Aug 2, 2020 Accepting new patients
Harbor of Hope Medical and Behavioral Health Care, LLC Family Past Accepting new patients

Locations

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1548755499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 TREUHAFT BLVD",
            "address_2": "SUITE 4",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409066780",
            "telephone_number": "160-654-5676",
            "fax_number": "606-545-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 TREUHAFT BLVD STE 4",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409064090",
            "telephone_number": "606-545-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "THELMA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.