Individual provider Active NPI

Stacy Chapman Gray, D.C.

  • Chiropractor
  • Raleigh, NC
National Provider Identifier
1811909120
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2200 Issued in NC
Practice address
4908 Professional CT
Raleigh, NC 27609-4914
Phone
(919) 850-2440
Fax
(919) 850-2441
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2200 NC Primary

Addresses

Primary practice location

4908 Professional CT
Raleigh, NC 27609-4914

Mailing address

4908 Professional CT
Raleigh, NC 27609-4914
Phone (919) 850-2440

Other identifiers 1

IdentifierTypeStateIssuer
890859FMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070608000081 NC Practitioner - Chiropractic 7113025503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4908 Professional Court
Raleigh, NC 27609-4914

4908 Professional CT
Raleigh, NC 27609-4914
Phone (919) 850-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2200NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gray Family Chiropractic, PLLC Chiropractor CurrentSince Jan 5, 2007 Accepting new patients

Locations

4908 Professional Ct
Raleigh, NC 27609
Phone (919) 850-2440

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1811909120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 PROFESSIONAL CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094914",
            "telephone_number": "919-850-2440",
            "fax_number": "919-850-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 PROFESSIONAL CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094914",
            "telephone_number": "919-850-2440",
            "fax_number": "919-850-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "STACY",
        "middle_name": "CHAPMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890859F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.