Bradley Thomas Gray, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2493855 Issued in MN

Practice address

11114 Almond Dr
Grey Eagle, MN 56336-4643

Phone

(605) 413-7349

NPI assigned

Jun 6, 2021

Last updated

Apr 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Adapt Kare Choices Corporation

  dba Adapt Kare Choices

  • Nursing Care Agency
  • Sauk Centre, MN
  • NPI 1659775518
  NPD Authorized official
• Additional Kare for Kids, Inc

  dba Additional Kare for Kids

  • Home Health Agency
  • Plano, TX
  • NPI 1639480056
  NPD
• Additional Kare for Kids, Inc.

  • Home Health Agency
  • Allen, TX
  • NPI 1104876291
  NPD

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

{
    "created_epoch": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1659948974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "GREY EAGLE",
            "state": "MN",
            "postal_code": "563360156",
            "telephone_number": "507-475-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11114 ALMOND DR",
            "city": "GREY EAGLE",
            "state": "MN",
            "postal_code": "563364643",
            "telephone_number": "605-413-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "BRADLEY",
        "middle_name": "THOMAS",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-06",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2493855",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "763648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley S Bertram
• Community Integrated Family Care Advocates (Cifca)
• Eagle's Crossing Adult Day Center

• Registered Nurse in Grey Eagle, MN
• Providers in Grey Eagle, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.

Verify at the official NPI Registry.