Jody Gray, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW30369 Issued in ID

Practice address

890 N Cole Rd
Boise, ID 83704-8638

Phone

(208) 322-1026

Fax

(208) 322-1029

NPI assigned

Jun 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pathways of Idaho LLCGroup PAC ID 4789808759, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pathways of Idaho, LLC

  dba Clarvida

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1326466988
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1821352329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048638",
            "telephone_number": "208-322-1026",
            "fax_number": "208-322-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048638",
            "telephone_number": "208-322-1026",
            "fax_number": "208-322-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JODY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW30369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Gray-Trent
• Abby Lynn Gray, NNP
• Elizabeth Marie Gray, FNP-C
• Erin K. Gray, FNP-BC
• Jennifer Gray, MD
• Jon R. Gray, D.C.
• Kenton Andrew Gray, BS, MC, LPC
• Laura Gray, MS, LPC
• Molly Elizabeth Gray, PT, DPT
• Tyson N. Gray, DMD

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.
• 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.