Individual provider Active NPI

Marjorie L Redd-Gray, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1790130029
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131025 Issued in TX
Practice address
1711 Doolittle Ave
Ft Worth, TX 76127-1133
Phone
(469) 449-3143
NPI assigned
Apr 23, 2016
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0416302 TX
Family Nurse Practitioner 363LF0000X AP131025 TX Primary

Addresses

Primary practice location

1711 Doolittle Ave
Ft Worth, TX 76127-1133

Mailing address

1711 Doolittle Ave
Ft Worth, TX 76127-1133
Phone (469) 449-3143

Other practice location 1

Brooke Army Medical Center
3551 Roger Brooke Dr
JBSA Fort Sam Houston, TX 78234-4504
Phone (210) 539-9271

Other practice location 2

PSC 851 Box 340
Fpo, AE 09834-0004
Phone (318) 439-7471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP131025TXMDFamily Nurse Practitioner
F0416302TXMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: marjorie.redd-gray.1@14940.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1461369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1790130029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 DOOLITTLE AVE",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761271133",
            "telephone_number": "469-449-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 DOOLITTLE AVE",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761271133",
            "telephone_number": "469-449-3143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Brooke Army Medical Center",
            "address_2": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "JBSA Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-539-9271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "PSC 851 Box 340",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AE",
            "postal_code": "098340004",
            "country_code": "US",
            "telephone_number": "318-439-7471",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "REDD-GRAY",
        "first_name": "MARJORIE",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-23",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F0416302",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.