Individual provider Active NPI

Andrew Jack Gray, MCD

  • Speech-Language Pathologist
  • Columbus, GA
National Provider Identifier
1801276704
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP008898 Issued in GA
Practice address
2424 Double Churches Rd
Columbus, GA 31909-2741
Phone
(706) 324-6112
Fax
(706) 596-8259
NPI assigned
Jun 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP008898 GA Primary

Addresses

Primary practice location

2424 Double Churches Rd
Columbus, GA 31909-2741

Mailing address

2424 Double Churches Rd
Columbus, GA 31909-2741
Phone (706) 324-6112

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

State licenses

LicenseStateTypeSpecialty
SLP008898GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1801276704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092741",
            "telephone_number": "706-324-6112",
            "fax_number": "706-596-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092741",
            "telephone_number": "706-324-6112",
            "fax_number": "706-596-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANDREW",
        "middle_name": "JACK",
        "credential": "MCD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.