Shannon K. Gray, RPH,CDE

Primary specialty

Health EducatorTaxonomy code 174H00000X

License

21410166 Issued in SC

Practice address

1594 Freedom Blvd
Suite 102 B
Florence, SC 29505-6046

Phone

(843) 674-2700

Fax

(843) 674-2729

NPI assigned

Dec 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1568827749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD",
            "address_2": "SUITE 102 B",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056046",
            "telephone_number": "843-674-2700",
            "fax_number": "843-674-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD",
            "address_2": "SUITE 102 B",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056046",
            "telephone_number": "843-674-2700",
            "fax_number": "843-674-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHANNON",
        "middle_name": "K.",
        "credential": "RPH,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "SC",
            "license": "21410166",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "9108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Thomas Gray
• Jessica Gray
• Melvenia Gray
• Pamola Gray
• Shainaria Lehoma Gray
• Green Spot Medispa LLC
• Andrian Jernise Green-Moore
• Ryan Sidney Green III, FNP-C
• Candice Whitaker Greenan, MD
• Phillip H Greenberg, M.D.

• Health Educator in Florence, SC
• Providers in Florence, SC by specialty
• Health Educator in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.