Angelica Reina Gray, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8172-C Issued in AR

Practice address

1217 Stone St
Jonesboro, AR 72401-4520

Phone

(870) 972-1268

NPI assigned

Sep 10, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1629479605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLESANT GROVE ROAD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72404",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 STONE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014520",
            "telephone_number": "870-972-1268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 Plesant Grove Road",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "72404",
            "country_code": "US",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANGELICA",
        "middle_name": "REINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "8172-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karson Jay Graves, RN
• Korey Graves, QBHP
• Gray Family Dentistry
• Amanda Gray
• Andrew A. Gray, DDS
• Barbara Frances Gray, APRN
• Billie Gray, LPN
• J. Brian Gray, O.D.
• Regina Gray, QBHP
• Sharon K Gray, LPN

• Clinical Social Worker in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.