Active NPI
David Kevin Gray, FNP-C
- Nurse Practitioner
- Princeton, WV
National Provider Identifier
1578528253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 50632
- Practice address
- 407 12TH Street Ext
Princeton, WV 24740-2300 - Phone
- (304) 487-0232
- Fax
- (304) 487-0285
- NPI assigned
- Apr 18, 2006
- Last updated
- Jul 10, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 50632 | WV | Primary |
Addresses
Primary practice location
407 12TH Street Ext
Princeton, WV 24740-2300
Mailing address
PO Box 5065
Princeton, WV 24740-5065
Phone (304) 487-0232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810003715 | Medicaid | WV |
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215648000000",
"number": "1578528253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5065",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247405065",
"telephone_number": "304-487-0232",
"fax_number": "304-487-0285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 12TH STREET EXT",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247402300",
"telephone_number": "304-487-0232",
"fax_number": "304-487-0285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DAVID",
"middle_name": "KEVIN",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2008-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WV",
"license": "50632",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810003715",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.