Susan Ann Gray

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT22849 Issued in FL

Practice address

12435 Jewel Stone LN
Fort Myers, FL 33913-6752

Phone

(239) 898-7302

NPI assigned

Nov 13, 2019

Sex

Female

Sole proprietor

No

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

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment NPD
• Southwest Florida Mobile Therapy, Inc.

  • Physical Therapist
  • Fort Myers, FL
  • NPI 1134730799
  NPD

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1841835964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12435 JEWEL STONE LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339136752",
            "telephone_number": "239-898-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12435 JEWEL STONE LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339136752",
            "telephone_number": "239-898-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "22849",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon L Grantham, ARNP-BC
• Jonathan Kenyon Grathwohl, DPT
• Adelaida Gray, ARNP
• Cindy M Gray
• Scott Gray, PT, DPT
• Toshie Grayson, PHARMD
• Amber Susan Greco, APRN
• Green Star Pharmacy
• Edward M Green, APRN
• John Justin Green, DO

• Physical Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.