Individual provider Active NPI

Jessica Gray

  • Clinical Social Worker
  • Dearborn, MI
National Provider Identifier
1821472382
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097974 Issued in MI
Practice address
5500 Auto Club Dr
Dearborn, MI 48126-2779
Phone
(313) 425-4500
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801097974 MI Primary

Addresses

Primary practice location

5500 Auto Club Dr
Dearborn, MI 48126-2779

Mailing address

2280 E Grand River Ave
Howell, MI 48843-8503
Phone (517) 546-4126

Other practice location 1

2280 E Grand River Ave
Howell, MI 48843-8503
Phone (517) 546-4126

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgray543498@direct.hfhs.org Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170811001060 MI Practitioner - Clinical Social Worker 8022389824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

5500 Auto Club Dr
Dearborn, MI 48126-2779
Phone (313) 425-4445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801097974MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Sep 1, 2018 Accepting new patients
Henry Ford Health System Clinical CurrentSince Sep 1, 2018 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • Direct secure messaging: jgray543498@direct.hfhs.org

Organizations & group practices 2

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1821472382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 E GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438503",
            "telephone_number": "517-546-4126",
            "fax_number": "517-546-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 AUTO CLUB DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262779",
            "telephone_number": "313-425-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2280 E Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488438503",
            "country_code": "US",
            "telephone_number": "517-546-4126",
            "fax_number": "517-546-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgray543498@direct.hfhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5500 Auto Club Dr",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481262779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.