NPIMap

Individual provider Active NPI

Susan Kay Gray, FNP

  • Family Nurse Practitioner
  • Onarga, IL
National Provider Identifier
1770616559
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
41-207013 Issued in IL
Practice address
109 N Chestnut
Onarga, IL 60955
Phone
(815) 268-4840
Fax
(815) 268-4845
NPI assigned
Mar 13, 2007
Last updated
Dec 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 41-207013 IL Primary

Addresses

Primary practice location

109 N Chestnut
Onarga, IL 60955

Mailing address

PO Box 77
109 N Chestnut
Onarga, IL 60955
Phone (815) 268-4840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051205000279 IL Practitioner - Nurse Practitioner 3476573551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4297

3 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4030

4 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4251

7 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-5500

912 W Seminary Ave
Onarga, IL 60955-1401
Phone (815) 268-4840

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41-207013ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Family CurrentSince May 2, 2012 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince May 2, 2012 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

122 E Wabash Ave
Forrest, IL 61741
Phone (815) 579-9002

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

109 N Chestnut St
Onarga, IL 60955
Phone (815) 268-0033

912 W Seminary Ave
Onarga, IL 60955
Phone (815) 268-4840

806 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-1078

Interoperability endpoints

  • Direct secure messaging: sue.gray.p6@direct.gapho.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1770616559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77",
            "address_2": "109 N CHESTNUT",
            "city": "ONARGA",
            "state": "IL",
            "postal_code": "60955",
            "telephone_number": "815-268-4840",
            "fax_number": "815-268-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N CHESTNUT",
            "city": "ONARGA",
            "state": "IL",
            "postal_code": "60955",
            "telephone_number": "815-268-4840",
            "fax_number": "815-268-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "41-207013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onarga, IL

Sources for this page

Verify at the official NPI Registry.