Individual provider Active NPI

Fayth-an Hope Gray, DNP, APRN, NP-C

  • Family Nurse Practitioner
  • Clinton, OK
National Provider Identifier
1609361872
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0086086 Issued in OK
Practice address
10321 N 2274 Rd
Clinton, OK 73601-7521
Phone
(580) 331-3300
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0086086 OK
Family Nurse Practitioner 363LF0000X R0086086 OK Primary

Addresses

Primary practice location

10321 N 2274 Rd
Clinton, OK 73601-7521

Mailing address

10321 N 2274 Rd
Clinton, OK 73601-7521
Phone (580) 331-3300

Other names 1

  • Fayth-an Hope Goldsberry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181212000229 TX Practitioner - Nurse Practitioner 1759625106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Reno Indian Health CenterGroup PAC ID 5193627263, 52 clinicians

Practice addresses (Care Compare)

1801 Parkview Dr
El Reno, OK 73036-2103
Phone (405) 234-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0086086OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton Indian Health Center CurrentSince Sep 19, 2018 Accepting new patients
El Reno Indian Health Center CurrentSince Apr 16, 2019 Accepting new patients

Locations

10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300

1801 Parkview Dr
El Reno, OK 73036
Phone (405) 234-5600

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1609361872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10321 N 2274 RD",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736017521",
            "telephone_number": "580-331-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10321 N 2274 RD",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736017521",
            "telephone_number": "580-331-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "FAYTH-AN",
        "middle_name": "HOPE",
        "credential": "DNP, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0086086",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0086086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAYTH-AN",
            "last_name": "GOLDSBERRY",
            "middle_name": "HOPE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton, OK

Sources for this page

Verify at the official NPI Registry.