Active NPI
Gray Allen Strode, CPRC,CPRM
- Prevention Professional
- Detroit, MI
National Provider Identifier
1841853009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- SA0803019
- Practice address
- 1121 E McNichols Rd
Detroit, MI 48203-2857 - Phone
- (313) 365-3100
- Fax
- (313) 365-3101
- NPI assigned
- Apr 15, 2019
- 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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | SA0803019 | MI | Primary |
Addresses
Primary practice location
1121 E McNichols Rd
Detroit, MI 48203-2857
Mailing address
1121 E McNichols Rd
Detroit, MI 48203-2857
Phone (313) 365-3100
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA0803019 | MI | MD | Prevention Professional |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One Step With Jesus Inc | Multi-Specialty | Current | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555286400000",
"number": "1841853009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 E MCNICHOLS RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482032857",
"telephone_number": "313-365-3100",
"fax_number": "313-365-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 E MCNICHOLS RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482032857",
"telephone_number": "313-365-3100",
"fax_number": "313-365-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRODE",
"first_name": "GRAY",
"middle_name": "ALLEN",
"name_prefix": "Prof.",
"credential": "CPRC,CPRM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-15",
"last_updated": "2019-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Prevention Professional",
"state": "MI",
"license": "SA0803019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.