Gary D Gray, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01454 Issued in IA

Practice address

855 A Ave NE
Suite 30
Cedar Rapids, IA 52402-5057

Phone

(319) 368-9300

Fax

(319) 368-5690

NPI assigned

Dec 30, 2005

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Gary Colletto PT

  • Physical Therapist
  • Granada Hills, CA
  • NPI 1508986233
  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1740267673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "address_2": "SUITE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-368-9300",
            "fax_number": "319-368-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "address_2": "SUITE 30",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-368-9300",
            "fax_number": "319-368-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "GARY",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "01454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128314",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "370022580",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740267673",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Grant
• Shelli L Grapp, ARNP
• Michelle L Gravert-Palmer, MHA
• Lauren Gravert, PHARMD
• Zandalee Hannah Graves
• Madelyn Michele Gray
• Matthew N Gray, MD
• Joan Marie Graybeal-Gillon, P.T.
• Great Plains Orthotics & Prosthetics, Inc
• Jocelyn Stella Grech

• Pediatrics Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.