Organization Active NPI

Gray Family Medicine

  • Family Medicine Physician
  • Bethesda, MD
National Provider Identifier
1588339428
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRAY FAMILY MEDICINE
Practice address
10401 Old Georgetown Rd Ste 304
Bethesda, MD 20814-1911
Phone
(301) 843-8008
NPI assigned
Aug 12, 2021
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Claudia Jordan
Title
Office Manager
Phone
(240) 372-9414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

10401 Old Georgetown Rd Ste 304
Bethesda, MD 20814-1911

Mailing address

10401 Old Georgetown Rd Ste 304
Bethesda, MD 20814-1911
Phone (301) 843-8008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220912000017 DC Part B Supplier - Clinic/Group Practice 7517342678 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2254734Gray Family Medicine10401 Old Georgetown Road, Suite 304, Bethesda, MD 20814Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAHGCD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1588339428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 OLD GEORGETOWN RD STE 304",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141911",
            "telephone_number": "301-843-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 OLD GEORGETOWN RD STE 304",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141911",
            "telephone_number": "301-843-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "240-372-9414"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.