Active NPI
Dorett Gray-Harris
- Licensed Practical Nurse
- Mount Vernon, NY
National Provider Identifier
1649412230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 294975
- Practice address
- 54 S 2ND Ave
Apt B-4
Mount Vernon, NY 10550-3438 - Phone
- (914) 363-3204
- NPI assigned
- Mar 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 294975 | NY | Primary |
Addresses
Primary practice location
54 S 2ND Ave
Apt B-4
Mount Vernon, NY 10550-3438
Mailing address
54 South 2ND Avenue
Apt B-4
Mount Vernon, NY 10550
Phone (914) 363-3204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1649412230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 SOUTH 2ND AVENUE",
"address_2": "APT B-4",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-363-3204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 S 2ND AVE",
"address_2": "APT B-4",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105503438",
"telephone_number": "914-363-3204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY-HARRIS",
"first_name": "DORETT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-30",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "294975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.