Lawrence A Gray, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 20219 Issued in CA

Practice address

4250 Fowler LN Ste 101
Diamond Springs, CA 95619-9782

Phone

(530) 409-0677

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gray Physical Therapy

  • Physical Therapist
  • Diamond Springs, CA
  • NPI 1639302631
  NPD Authorized official

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861598542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 FOWLER LANE, STE 101",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199782",
            "telephone_number": "530-409-0677",
            "fax_number": "530-295-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 FOWLER LN STE 101",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199782",
            "telephone_number": "530-409-0677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Placerville Dr",
            "address_2": "Suite K",
            "address_purpose": "LOCATION",
            "city": "Placerville",
            "state": "CA",
            "postal_code": "956674046",
            "country_code": "US",
            "telephone_number": "530-642-0677",
            "fax_number": "530-295-8266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 20219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Goode, MFT
• Mitchell Allen Goodis, D.D.S.
• Tommi Graening
• Gray Physical Therapy
• Brooke Gray
• Michelle Green
• Denise Louise Gruber
• Jill Gustafson, LCSW
• Samantha Guthrie
• Alfonso Gutierrez

• Physical Therapist in Diamond Springs, CA
• Providers in Diamond Springs, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.