Active NPI
Charlene Gray
- Occupational Therapist
- Fremont, NE
National Provider Identifier
1588089452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 114532
- Practice address
- 1005 E 23Rd St
Suite 200
Fremont, NE 68025-0800 - Phone
- (866) 784-2329
- NPI assigned
- Feb 28, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 114532 | TX | Primary |
Addresses
Primary practice location
1005 E 23Rd St
Suite 200
Fremont, NE 68025-0800
Mailing address
15702 Seekers St
San Antonio, TX 78255-3302
Phone (210) 392-3184
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114532 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RTG Medical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Fremont, NE
- NPI 1215206024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393545600000",
"number": "1588089452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15702 SEEKERS ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782553302",
"telephone_number": "210-392-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 E 23RD ST",
"address_2": "SUITE 200",
"city": "FREMONT",
"state": "NE",
"postal_code": "680250800",
"telephone_number": "866-784-2329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "CHARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-28",
"last_updated": "2014-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.