NPIMap

Individual provider Active NPI

Coleman Gray I, PTA

  • Physical Therapy Assistant
  • Ft Rucker, AL
National Provider Identifier
1679742001
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
Physical Therapy Clinic
Lyster Army Health Clinic
Ft Rucker, AL 36362
Phone
(334) 255-7169
NPI assigned
Feb 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

Physical Therapy Clinic
Lyster Army Health Clinic
Ft Rucker, AL 36362

Mailing address

Physical Therapy Clinic
Lyster Army Health Clinic
Ft Rucker, AL 36362

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": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1679742001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PHYSICAL THERAPY CLINIC",
            "address_2": "LYSTER ARMY HEALTH CLINIC",
            "city": "FT RUCKER",
            "state": "AL",
            "postal_code": "36362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PHYSICAL THERAPY CLINIC",
            "address_2": "LYSTER ARMY HEALTH CLINIC",
            "city": "FT RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "334-255-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "COLEMAN",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.