Individual provider Active NPI

Gray Lyon Garrett, CRNP

  • Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1720244841
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-097461 Issued in AL
Practice address
251 N Bayou St
Mobile, AL 36603-5827
Phone
(251) 690-8158
Fax
(251) 544-2188
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-097461 AL Primary

Addresses

Primary practice location

251 N Bayou St
Mobile, AL 36603-5827

Mailing address

PO Box 2867
Mobile, AL 36652-2867
Phone (251) 690-8158

Other identifiers 3

IdentifierTypeStateIssuer
1063439065OtherALSITE GROUP PAYEE NUMBER
011846OtherALMEDICARE GROUP PAYEE NUMBER
630000013MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-097461ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
D.W. McMillan Memorial Hospital CurrentSince Nov 10, 2018 Accepting new patients
Escambia County Health Care Authority CurrentSince Oct 3, 2016 Accepting new patients
Greater Mobile Urgent Care CurrentSince Oct 1, 2022 Accepting new patients
Escambia County Health Care Authority CurrentSince Oct 3, 2016 Accepting new patients
D.W. McMillan Memorial Hospital CurrentSince Nov 10, 2018 Accepting new patients
Gmuc of Springhill LLC CurrentSince Oct 1, 2022 Accepting new patients
Greater Mobile Urgent Care CurrentSince Oct 1, 2022 Accepting new patients

Locations

1108 Douglas Ave
Brewton, AL 36426
Phone (251) 867-1711

1301 Belleville Ave
Brewton, AL 36426
Phone (251) 809-8439

19355 N 3rd St
Ste 104
Citronelle, AL 36522
Phone (251) 633-0123

174 Highway 113
Flomaton, AL 36441
Phone (251) 296-2456

4402 Old Shell Rd
Mobile, AL 36608
Phone (251) 633-0123

2350 Schillinger Rd S
Ste A
Mobile, AL 36695
Phone (251) 633-0123

1114 Shelton Beach Rd
Saraland, AL 36571
Phone (251) 633-0123

7943 Moffett Rd
Semmes, AL 36575
Phone (251) 445-7618

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a7b7f339-eea5-408f-8f14-ad4341b10c45/

Organizations & group practices 7

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1720244841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2867",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522867",
            "telephone_number": "251-690-8158",
            "fax_number": "251-544-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N BAYOU ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035827",
            "telephone_number": "251-690-8158",
            "fax_number": "251-544-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "GRAY",
        "middle_name": "LYON",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-097461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE GROUP PAYEE NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PAYEE NUMBER",
            "identifier": "011846",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.