Individual provider Active NPI

Kristen David Gray, M.D.

  • Family Medicine Physician
  • Sanford, FL
National Provider Identifier
1861481517
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME85090 Issued in FL
Practice address
401 Towne Center Blvd
Sanford, FL 32771-7407
Phone
(407) 200-0547
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 80188 CT
Family Medicine Physician 207Q00000X ME85090 FL Primary

Addresses

Primary practice location

401 Towne Center Blvd
Sanford, FL 32771-7407

Mailing address

401 Towne Center Blvd
Sanford, FL 32771-7407
Phone (407) 200-0547

Other practice location 1

7400 Docs Grove Cir
Orlando, FL 32819-8010
Phone (407) 352-9717

Other identifiers 5

IdentifierTypeStateIssuer
593339550OtherFLTAX IDENTIFICATION NUMBER
264274300MedicaidFL
K9529OtherFLMEDICARE GROUP NUMBER
592696120OtherFLTAX IDENIFICATION
593339550OtherFLWINTER PARK FAMILY HEALTH CENTER, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331000996 FL Practitioner - Family Practice 7911802442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2940 S US Hwy 1
Suite C11 Wellmed at Fort Pierce
Fort Pierce, FL 34982-8143
Phone (772) 466-6855

7400 Docs Grove Cir
Orlando, FL 32819-8010
Phone (407) 352-9717

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80188CTMDFamily Medicine Physician
ME85090FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family Medicine CurrentSince Apr 7, 2025 Accepting new patients
Optumcare Florida LLC Family Medicine PastSince Dec 16, 2010 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

415 Killingworth Rd
Higganum, CT 06441
Phone (860) 345-4538

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1861481517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 TOWNE CENTER BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717407",
            "telephone_number": "407-200-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 TOWNE CENTER BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717407",
            "telephone_number": "407-200-0547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7400 Docs Grove Cir",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328198010",
            "country_code": "US",
            "telephone_number": "407-352-9717",
            "fax_number": "407-354-5425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KRISTEN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "80188",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME85090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "593339550",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264274300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "K9529",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENIFICATION",
            "identifier": "592696120",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WINTER PARK FAMILY HEALTH CENTER, INC",
            "identifier": "593339550",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

Verify at the official NPI Registry.