Elizabeth Gray, QBHP

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1004 S Main St
Berryville, AR 72616-4330

Phone

(870) 423-1077

NPI assigned

Jan 23, 2013

Last updated

Jul 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1699013813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4171 N CROSSOVER RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034591",
            "telephone_number": "479-521-1427",
            "fax_number": "479-521-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S MAIN ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164330",
            "telephone_number": "870-423-1077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Fort St Ste A",
            "address_purpose": "LOCATION",
            "city": "Barling",
            "state": "AR",
            "postal_code": "729232180",
            "country_code": "US",
            "telephone_number": "479-494-5700",
            "fax_number": "479-484-8142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ELIZABETH",
        "credential": "QBHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195097795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Berryville, AR
• Providers in Berryville, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.