Active NPI
Diane Gray, RN
- Registered Nurse
- Jonesboro, GA
National Provider Identifier
1851538284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN104383
- Practice address
- 646 Washington Dr
Jonesboro, GA 30238-8516 - Phone
- (404) 964-0298
- Fax
- (770) 252-1102
- NPI assigned
- Jan 7, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN104383 | GA | Primary |
Addresses
Primary practice location
646 Washington Dr
Jonesboro, GA 30238-8516
Mailing address
646 Washington Drive
Jonesboro, GA 30238
Phone (404) 964-0298
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN104383 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1851538284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "646 WASHINGTON DRIVE",
"city": "JONESBORO",
"state": "GA",
"postal_code": "30238",
"telephone_number": "404-964-0298",
"fax_number": "770-252-1102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "646 WASHINGTON DR",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302388516",
"telephone_number": "404-964-0298",
"fax_number": "770-252-1102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN104383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.