Individual provider Active NPI

Ayanna Natasha Gray-Bolden, CRNP

  • Women's Health Nurse Practitioner
  • Newark, DE
National Provider Identifier
1831456888
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
LG-0011631 Issued in DE
Practice address
1 Centurian Dr Ste 312
Newark, DE 19713-2127
Phone
(302) 319-5680
Fax
(302) 319-5681
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X LG-0011631 DE Primary
Nurse Practitioner 363L00000X LG-0011631 DE
Family Nurse Practitioner 363LF0000X SP011305 PA

Addresses

Primary practice location

1 Centurian Dr Ste 312
Newark, DE 19713-2127

Mailing address

1 Centurian Dr Ste 312
Newark, DE 19713-2127
Phone (302) 319-5680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210702000503 DE Practitioner - Nurse Practitioner 3375707631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Centurian Dr
Newark, DE 19713-2127
Phone (302) 319-5680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP011305PAMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1831456888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CENTURIAN DR STE 312",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132127",
            "telephone_number": "302-319-5680",
            "fax_number": "302-319-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTURIAN DR STE 312",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132127",
            "telephone_number": "302-319-5680",
            "fax_number": "302-319-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY-BOLDEN",
        "first_name": "AYANNA",
        "middle_name": "NATASHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "DE",
            "license": "LG-0011631",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0011631",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.