Robert Bourdeaux Gray, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35942 Issued in KY

Practice address

305 Estill St
Berea, KY 40403-1742

Phone

(859) 986-3151

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment NPD
• Gmuc of Springhill LLC

  • Family Medicine Physician
  • Mobile, AL
  • NPI 1952617508
  Medicare reassignment NPD
• Greater Mobile Urgent Care

  • Family Medicine Physician
  • Mobile, AL
  • NPI 1801063938
  Medicare reassignment NPD
• Greater Mobile Urgent Care

  • Family Medicine Physician
  • Semmes, AL
  • NPI 1275848095
  NPD
• Keightley & Parsley P S C

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1386670503
  NPD (past)
• Acute Care Specialists, Inc.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1447294640
  NPD (past)
• Consultorio Medico Latino

  • Family Medicine Physician
  • North Charleston, SC
  • NPI 1790319408
  NPD (past)
• Dr Arias LLC

  • Internal Medicine Physician
  • North Charleston, SC
  • NPI 1114126372
  NPD (past)
• North Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Laurinburg, NC
  • NPI 1003861386
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1811942014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4390 CLEARWATER WAY",
            "address_2": "APT 1110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156359",
            "telephone_number": "859-971-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-986-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROBERT",
        "middle_name": "BOURDEAUX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "35942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64018179",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fresenius Medical Care Nak Berea, LLC
• Friends and Family Activity Center
• Pamela Renae Fugate, APRN
• Allison Gerrard
• Susan L Gibson, PHARMD
• H2 Rehabilitation Services of Kentucky, LLC
• Bill Junior Hacker, M.D.
• Vicki Lou Hackman, MD
• Amanda Jane Hale, MA, CCC-SLP
• Donita Hardy, PA

• Emergency Medicine Physician in Berea, KY
• Providers in Berea, KY by specialty
• Emergency Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.