Individual provider Active NPI

Gilliann Gray

  • Occupational Therapist
  • Collierville, TN
National Provider Identifier
1790410702
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
The Farms at Bailey Station
3300 S Houston Levee Rd
Collierville, TN 38107
Phone
(901) 779-8200
NPI assigned
Jul 22, 2022
Last updated
Jul 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

The Farms at Bailey Station
3300 S Houston Levee Rd
Collierville, TN 38107

Mailing address

100 Kilmory Dr
Rossville, TN 38066-3676
Phone (901) 486-6837

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL securerecords.sanford.html Direct Functional Pathways

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221214000556 TN Practitioner - Occupational Therapist in Private Practice 7113396193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

2180 Mangum Rd
Memphis, TN 38134-5810
Phone (901) 307-7741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jan 12, 2024 Accepting new patients
Ave Maria Home CurrentSince Nov 14, 2022 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jan 12, 2024 Accepting new patients
Doug Hassenpflug PLLC PastSince Jul 24, 2022 Accepting new patients
Luke Inc. PastSince Jul 24, 2022 Accepting new patients
Shelby County Board of Education Past Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

2805 Charles Bryan Rd
Bartlett, TN 38134
Phone (901) 386-3211

2180 Mangum Rd
Memphis, TN 38134
Phone (901) 307-7741

Organizations & group practices 7

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": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1790410702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KILMORY DR",
            "city": "ROSSVILLE",
            "state": "TN",
            "postal_code": "380663676",
            "telephone_number": "901-486-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE FARMS AT BAILEY STATION",
            "address_2": "3300 S HOUSTON LEVEE RD",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "38107",
            "telephone_number": "901-779-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "GILLIANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "Y",
            "endpointDescription": "HTML",
            "affiliationName": "Functional Pathways",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3300 S Houston Levee Rd",
            "city": "Collierville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380171344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.