Individual provider Active NPI

Christina Gray, RN,MSN,ANP

  • Adult Health Nurse Practitioner
  • Auburn, NY
National Provider Identifier
1659392173
Registry record updated Nov 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F301383-1 Issued in NY
Practice address
37 W Garden St
Suite #201
Auburn, NY 13021-2662
Phone
(315) 567-0777
Fax
(315) 702-8393
NPI assigned
Jul 21, 2006
Last updated
Nov 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F301383-1 NY Primary

Addresses

Primary practice location

37 W Garden St
Suite #201
Auburn, NY 13021-2662

Mailing address

17 Lansing St
Amms, PC Credentialing Office
Auburn, NY 13021-1983
Phone (315) 567-0455

Other identifiers 1

IdentifierTypeStateIssuer
01790427MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201120000018 NY Order and Referring Only - Nurse Practitioner 8921075573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F301383-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soldiers & Sailors Memorial Hospital Past Accepting new patients
Geneva General Hospital Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: c.gray@flhmedical.medentdirect.com

Organizations & group practices 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448582400000",
    "number": "1659392173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "address_2": "AMMS, PC CREDENTIALING OFFICE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-567-0455",
            "fax_number": "315-253-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W GARDEN ST",
            "address_2": "SUITE #201",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130212662",
            "telephone_number": "315-567-0777",
            "fax_number": "315-702-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CHRISTINA",
        "credential": "RN,MSN,ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301383-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01790427",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.