Individual provider Active NPI

Robert Jeffrey Gray, RN, CSA

  • Orthopedic Registered Nurse
  • Indianapolis, IN
National Provider Identifier
1811196702
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Registered NurseTaxonomy code 163WX0800X
License
28073597A Issued in IN
Practice address
201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301
Phone
(317) 817-1200
Fax
(317) 208-1551
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Registered Nurse 163WX0800X 28073597A IN Primary
Surgical Technologist 246ZS0410X

Addresses

Primary practice location

201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301

Mailing address

201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-1393
Phone (317) 817-1200

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28073597AINMDOrthopedic Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1811196702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462801393",
            "telephone_number": "317-817-1200",
            "fax_number": "317-208-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802301",
            "telephone_number": "317-817-1200",
            "fax_number": "317-208-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROBERT",
        "middle_name": "JEFFREY",
        "credential": "RN, CSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "IN",
            "license": "28073597A",
            "primary": true
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.