Individual provider Active NPI

Richard W. Gray, P.T.

  • Physical Therapist
  • Tallahassee, FL
National Provider Identifier
1609049352
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1834A Jaclif CT
Tallahassee, FL 32308-4400
Phone
(850) 656-1837
Fax
(850) 877-2917
NPI assigned
Apr 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1834A Jaclif CT
Tallahassee, FL 32308-4400

Mailing address

1834A Jaclif CT
Tallahassee, FL 32308-4400
Phone (850) 656-1837

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080702000154 FL Practitioner - Physical Therapist in Private Practice 8325110638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopedic and Sports Physical Therapy P aGroup PAC ID 7810069127, 24 clinicians

Practice addresses (Care Compare)

2615 Centennial Blvd
Suite 101
Tallahasse, FL 32308-0589
Phone (850) 656-1837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4626OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Imc of Alabama Physical Therapist Current Accepting new patients
Imc of South Carolina Physical Therapist PastSince Aug 1, 2012 Accepting new patients

Locations

2615 Centennial Blvd
Ste 101
Tallahassee, FL 32308

Organizations & group practices 3

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1609049352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834A JACLIF CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084400",
            "telephone_number": "850-656-1837",
            "fax_number": "850-877-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834A JACLIF CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084400",
            "telephone_number": "850-656-1837",
            "fax_number": "850-877-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "RICHARD",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.