Individual provider Active NPI

Garry Grey, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1750329009
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17722 Issued in CA
Practice address
2801 L St
Sacramento, CA 95816-5615
Phone
(916) 733-3003
NPI assigned
Jun 2, 2006
Last updated
Jul 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17722 CA Primary

Addresses

Primary practice location

2801 L St
Sacramento, CA 95816-5615

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060720000178 CA Practitioner - Physician Assistant 8820001670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17722CAMDPhysician Assistant
17722CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ampla Health CurrentSince Sep 26, 2016 Accepting new patients
Ampla Health CurrentSince Sep 26, 2016 Accepting new patients

Locations

2800 Lincoln St
Oroville, CA 95966
Phone (530) 534-7500

935 Market St
Yuba City, CA 95991
Phone (530) 674-4261

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1750329009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 L ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165615",
            "telephone_number": "916-733-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "GARRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.