Active NPI
Kelly Gray
- Pharmacist
- Hagerstown, MD
National Provider Identifier
1659081347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202218054
- Practice address
- 11116 Medical Campus Rd
Hagerstown, MD 21742-6710 - Phone
- (301) 790-8000
- NPI assigned
- Dec 2, 2022
- Last updated
- Dec 2, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202218054 | VA | Primary |
Addresses
Primary practice location
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Mailing address
261 Leviticus Dr
Bunker Hill, WV 25413-3597
Phone (540) 429-5230
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202218054 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1659081347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 LEVITICUS DR",
"city": "BUNKER HILL",
"state": "WV",
"postal_code": "254133597",
"telephone_number": "540-429-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11116 MEDICAL CAMPUS RD",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217426710",
"telephone_number": "301-790-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-02",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202218054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.