Kimberly A Gray, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

121272 Issued in MO

Practice address

620 S Taylor Ave
Div Im Infectious Disease, Ste 100
Saint Louis, MO 63110-1035

Phone

(314) 362-9098

Fax

(314) 362-9851

NPI assigned

Feb 21, 2007

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

Electronic endpoints 1

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1992746903
  NPD
• County of St Louis Division of Fiscal Management

  dba John C. Murphy Health Center

  • Federally Qualified Health Center (FQHC)
  • Berkeley, MO
  • NPI 1184519506
  NPD (past)
• County of St Louis Division of Fiscal Management

  dba St Louis County Dept of Health

  • State or Local Public Health Clinic/Center
  • Saint Louis, MO
  • NPI 1780639088
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1730224999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8052",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-1700",
            "fax_number": "314-362-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S TAYLOR AVE",
            "address_2": "DIV IM INFECTIOUS DISEASE, STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101035",
            "telephone_number": "314-362-9098",
            "fax_number": "314-362-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "121272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427003702",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "620 S Taylor Ave",
            "address_2": "Div IM Infectious Disease, Ste 100",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ian J Gray, NNP-BC
• Jannysse Elizabeth Gray, RN
• Jennifer Margery Gray, MD
• Katlin Alicia Gray, PA
• Katy E Gray, MD
• Marta R Gray, F.N.P.
• Martha A Gray, LPC-S, RPT-S
• Mary M Gray, LCSW
• Megan Renee Gray
• Mellaney Gray, SLP M.S.

• Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.