Mindy M. Gray, MS, RDN
Individual provider Active NPI Registered Dietitian · Grain Valley, MO
NPI 1669968236 · NPPES record last updated Jul 7, 2018
Key facts
- NPI
- 1669968236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1486 (KS)
- Practice address
- 1431 NW Willow Dr
Grain Valley, MO 64029-8006 - Phone
- (816) 519-2175
- NPI assigned
- Jul 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
236 5TH Ave
FL 4
New York, NY 10001-7737
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250911001170 | MO | Practitioner - Registered Dietitian Or Nutrition Professional | 8224531702 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1486 | KS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifemd Midwest Patient Medical Care PC | Single Specialty | Current |
Accepting new patients |
| Lifemd South Central Patient Medical Care PA | Single Specialty | Current |
Accepting new patients |
| Lifemd New England Patient Medical Care PA | Single Specialty | Current |
Accepting new patients |
| Lifemd Southern Patient Medical Care PC | Single Specialty | Current |
Accepting new patients |
| Lifemd Kansas Patient Medical Care PA | Single Specialty | Current |
Accepting new patients |
| Puopolo MD PC | Single Specialty | Current |
Accepting new patients |
| Lifemd Atlantic Patient Medical Care PC | Single Specialty | Current |
Accepting new patients |
| New York Patient Medical Care PC | Single Specialty | Current |
Accepting new patients |
| Body Lab | Current | Accepting new patients |
Locations
83 Wooster Hts
Ste 125
Danbury, CT 06810
Phone (475) 289-7864
875 N Michigan Ave
Fl 31
Chicago, IL 60611
Phone (312) 794-7730
236 5th Ave
Fl 4
New York, NY 10001
Phone (212) 686-0587
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | 1486 | KS | Yes |
Addresses
Primary practice location
1431 NW Willow Dr
Grain Valley, MO 64029-8006
Mailing address
PO Box 502
Grain Valley, MO 64029-0502
Phone (816) 519-2175
Other providers in Grain Valley, MO
- Jamie Gibson
- Rachel E Gordon
- Grain Valley Center for Functional Medicine
- Grain Valley Chiropractic, LLC
- Grain Valley R-V School District
- Erin Griesbauer
- Samantha Jo Griesinger
- Alexa Gust
- Gracelyn Marie Gutierrez
- Malia Kelly, Alexis Gutierrez
All providers in Grain Valley, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.