Kelley B Gray

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01577 Issued in MO

Practice address

Bismarck R-V School District
101 Dennis Dr
Bismarck, MO 63624-0257

Phone

(573) 734-6111

Fax

(573) 734-2957

NPI assigned

Apr 27, 2007

Last updated

Feb 23, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bismarck R-V School District

  • Local Education Agency (LEA)
  • Bismarck, MO
  • NPI 1003956475

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1629298989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 257",
            "address_2": "101 DENNIS DR",
            "city": "BISMARCK",
            "state": "MO",
            "postal_code": "636240257",
            "telephone_number": "573-734-6111",
            "fax_number": "573-734-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BISMARCK R-V SCHOOL DISTRICT",
            "address_2": "101 DENNIS DR",
            "city": "BISMARCK",
            "state": "MO",
            "postal_code": "636240257",
            "telephone_number": "573-734-6111",
            "fax_number": "573-734-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KELLEY",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "01577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463138024",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bismarck R-V School District
• Bre Medical Providers LLC (Bismarck Medical Providers)
• Joseph Christopher Cangelosi, D.D.S.
• Colonial Retirement Center Inc. (Colonial Residential Care Facility II)
• Victoria Nicole Eftink, M.A. CCC-SLP
• Laura E Haynes, PHARMD
• Healthy Life Pharmacy LLC
• Healthy Life Pharmacy LLC (Healthy Life Pharmacy)
• Andrea M Kellerman
• Sheila Jane Reynolds-Dempsey

• Speech-Language Pathologist in Bismarck, MO
• Providers in Bismarck, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.