Active NPI
Brian Keith Gray, D.C.
- Chiropractor
- Osceola, WI
National Provider Identifier
1831270859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3833
- Practice address
- 2391B Highway 35
Osceola, WI 54020-0129 - Phone
- (715) 294-1753
- Fax
- (715) 294-1754
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3833 | WI | Primary |
Addresses
Primary practice location
2391B Highway 35
Osceola, WI 54020-0129
Mailing address
PO Box 129
Osceola, WI 54020-0129
Phone (715) 294-1753
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 312T3N0 | Other | BLUE CROSS/ BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3833 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
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.
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- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831270859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 129",
"city": "OSCEOLA",
"state": "WI",
"postal_code": "540200129",
"telephone_number": "715-294-1753",
"fax_number": "715-294-1754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2391B HIGHWAY 35",
"city": "OSCEOLA",
"state": "WI",
"postal_code": "540200129",
"telephone_number": "715-294-1753",
"fax_number": "715-294-1754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "BRIAN",
"middle_name": "KEITH",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "3833",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/ BLUE SHIELD",
"identifier": "312T3N0",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Osceola, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.