Captain K Gray, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0416656 Issued in KS

Practice address

10777 Nall Ave
#315
Overland Park, KS 66211-1362

Phone

(913) 345-2622

Fax

(913) 345-2699

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Affinity Sports Medicine, LLC

  • Sports Medicine (Family Medicine) Physician
  • Kansas City, MO
  • NPI 1982114302
  NPD (past)
• USA Vein Clinics of Decatur LLC

  • Vascular Surgery Physician
  • Decatur, GA
  • NPI 1912301003

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1861451346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD",
            "address_2": "STE 300",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151069",
            "telephone_number": "630-725-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE",
            "address_2": "#315",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111362",
            "telephone_number": "913-345-2622",
            "fax_number": "913-345-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CAPTAIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "KS",
            "license": "0416656",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0416656",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "117885",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q2669",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "TN",
            "license": "MD0000054563",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CT",
            "license": "56083",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF KANSAS CITY",
            "identifier": "17344014",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF KANSAS CITY",
            "identifier": "17344024",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110132045",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexa Kathryn Graves, PHARMD
• Heather Marie Graves, MA, LCPC, LMAC, NCC
• Jeffery Justin Graves, MD
• Kyndall Graves
• Lariah Graves
• Danni Pauline Gray, PA-C
• Emily M. Gray, CRNA
• Stefanie Gray, D.D.S.
• Chris R Greathouse, PHARM D
• Green Hills Chiropractic and Acupuncture P.C.

• Internal Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.