Individual provider Active NPI

Sarah Spitzfaden Gray, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1619416351
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07084 Issued in NC
Practice address
4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462
Phone
(919) 589-1204
Fax
(919) 589-1264
NPI assigned
Feb 14, 2017
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07084 NC Primary

Addresses

Primary practice location

4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462

Mailing address

4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462
Phone (919) 589-1204

Other practice location 1

1021 Darrington Dr Ste 101
Cary, NC 27513-8158
Phone (919) 852-3999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170510000025 NC Practitioner - Physician Assistant 8123305646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Wellness Behavioral HealthGroup PAC ID 6507244498, 8 clinicians

Practice addresses (Care Compare)

613 Maywood Ave
Raleigh, NC 27603-2339
Phone (919) 582-6776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07084NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Generations Family Practice, PA CurrentSince Mar 1, 2020 Accepting new patients
Generations Family Practice, PA CurrentSince Mar 1, 2020 Accepting new patients

Locations

1021 Darrington Dr
Ste 101
Cary, NC 27513
Phone (919) 852-3339

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1619416351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-589-1204",
            "fax_number": "919-589-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-589-1204",
            "fax_number": "919-589-1264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Darrington Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138158",
            "country_code": "US",
            "telephone_number": "919-852-3999",
            "fax_number": "919-378-9114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SARAH",
        "middle_name": "SPITZFADEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.