Michelle Marie Gray

Primary specialty

DriverTaxonomy code 172A00000X

License

Z164274002 Issued in MO

Practice address

340 Harwood Ave
Lebanon, MO 65536-2318

Phone

(417) 991-2221

NPI assigned

Mar 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1821856527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 HARWOOD AVE",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655362318",
            "telephone_number": "417-991-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HARWOOD AVE",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655362318",
            "telephone_number": "417-991-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "MO",
            "license": "Z164274002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeramie Sousa Gorman, PLPC
• Mary Kathryn Goslin, LPC
• Monika Goyal, MD
• Jason G Grant, CRNA
• William Grant III, O.D.
• Cathy Jane Greenlee, FNP-C
• Bayli Lenn Griffin, DPT
• Catherine A Grigg, PSYD
• Tyler Grout, D.P.M.
• John C. Gullage, PA-C

• All providers in Lebanon, MO
• Driver in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.