Organization Active NPI

Gray Family Chiropractic, PLLC

  • Chiropractor
  • Raleigh, NC
National Provider Identifier
1710076302
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2200 Issued in NC
Legal business name
GRAY FAMILY CHIROPRACTIC, PLLC
Practice address
4908 Professional CT
Raleigh, NC 27609-4914
Phone
(919) 850-2440
Fax
(919) 850-2441
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Dr. Stacy Gray, DCNPI 1811909120
Title
Owner
Phone
(919) 850-2440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2200 NC Primary

Addresses

Primary practice location

4908 Professional CT
Raleigh, NC 27609-4914

Mailing address

4908 Professional CT
Raleigh, NC 27609-4914
Phone (919) 850-2440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070608000092 NC Part B Supplier - Clinic/Group Practice 7012015407 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

4908 Professional Ct
Raleigh, NC 27609
Phone (919) 850-2440

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1710076302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 PROFESSIONAL CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094914",
            "telephone_number": "919-850-2440",
            "fax_number": "919-850-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 PROFESSIONAL CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094914",
            "telephone_number": "919-850-2440",
            "fax_number": "919-850-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-850-2440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.