Individual provider Active NPI

Donald Jason Gray, D.C.

  • Chiropractor
  • Cincinnati, OH
National Provider Identifier
1720173552
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3464 Issued in OH
Practice address
6934 Montgomery Rd
Cincinnati, OH 45236-3821
Phone
(513) 792-0070
Fax
(513) 792-0466
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3464 OH Primary

Addresses

Primary practice location

6934 Montgomery Rd
Cincinnati, OH 45236-3821

Mailing address

3700 Garden CT
Grove City, OH 43123-2906
Phone (513) 792-0070

Other identifiers 3

IdentifierTypeStateIssuer
2641789MedicaidOH
8585002418002MedicaidOH
000000350968OtherOHANTHEM BC/BS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4734KYMDSocial Worker
3464OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenwood Family Chiropractic LLC Chiropractor PastSince Jul 26, 2012 Accepting new patients
Buckeye Physical Medicine and Rehab - Kenwood PastSince Jun 25, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720173552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 GARDEN CT",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431232906",
            "telephone_number": "513-792-0070",
            "fax_number": "513-792-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6934 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452363821",
            "telephone_number": "513-792-0070",
            "fax_number": "513-792-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DONALD",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2641789",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8585002418002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000350968",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.