Nicole Lynn Gray

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

License

NT-10189794 Issued in OR

Practice address

413 NW 3Rd St
413 NW 3Rd St
Prineville, OR 97754

Phone

(541) 291-3488

NPI assigned

Oct 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1831911536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 NW 3RD ST",
            "address_2": "413 NW 3RD STREET",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "97754",
            "telephone_number": "541-291-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 NW 3RD ST",
            "address_2": "413 NW 3RD ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "97754",
            "telephone_number": "541-291-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "OR",
            "license": "NT-10189794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Tbd",
            "affiliation": "N",
            "endpointDescription": "Tbd",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "413 NW 3RD ST",
            "address_2": "413 NW 3RD ST",
            "city": "Prineville",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meghan Sharon Goldman
• Cassandra Star Gonzalez, B.S., B.A., QMHA
• Silvia C Gonzalez, CADC I
• Natalie Trent Good, DO
• Laura Danielle Gratton, D.O.
• Alexandra M Greenberg, DC
• Carol Ann Gregory
• Kristin Nicole Grisewood
• Douglas Chester Gruzd, MD
• Nelda J Grymes, RN

• Technician/Technologist in Prineville, OR
• Providers in Prineville, OR by specialty
• Technician/Technologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.