Active NPI
Gary Charles Gray, LCSW
- Social Worker
- Fayetteville, AR
National Provider Identifier
1861422495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- C486
- Practice address
- 1681 N Starr Dr
Fayetteville, AR 72701-2936 - Phone
- (479) 442-4958
- NPI assigned
- Jul 3, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | C486 | AR | Primary |
Addresses
Primary practice location
1681 N Starr Dr
Fayetteville, AR 72701-2936
Mailing address
1681 N Starr Dr
Fayetteville, AR 72701-2936
Phone (479) 442-4958
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C486 | AR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861422495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1681 N STARR DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727012936",
"telephone_number": "479-442-4958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1681 N STARR DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727012936",
"telephone_number": "479-442-4958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "GARY",
"middle_name": "CHARLES",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "C486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.