Individual provider Active NPI

Shalane Gray

  • Personal Care Attendant
  • Memphis, TN
National Provider Identifier
1699379636
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
L000000027082 Issued in TN
Practice address
3874 Viscount Ave #3
Memphis, TN 38118
Phone
(901) 727-8684
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X TN
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X L000000027082 TN Primary

Addresses

Primary practice location

3874 Viscount Ave #3
Memphis, TN 38118

Mailing address

3874 Viscount Ave #3
Memphis, TN 38118
Phone (901) 727-8684

Other practice location 1

1275 Hall Valley Cove
Cordova, TN 38018
Phone (901) 301-4295

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

State licenses

LicenseStateTypeSpecialty
L000000027082TNMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1699379636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3874 VISCOUNT AVE #3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38118",
            "telephone_number": "901-727-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 VISCOUNT AVE #3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38118",
            "telephone_number": "901-727-8684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 Hall Valley Cove",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "38018",
            "country_code": "US",
            "telephone_number": "901-301-4295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHALANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "TN",
            "license": "L000000027082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.