Mariette Zanders Gray, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11009858 Issued in FL

Practice address

100 N Main St
Chattahoochee, FL 32324-1107

Phone

(850) 663-7383

NPI assigned

Nov 2, 2020

Last updated

Nov 2, 2020By the provider in NPPES

Sex

Female

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Department of Children and Families

  dba Florida State Hospital-Unit 31

  • General Acute Care Hospital
  • Chattahoochee, FL
  • NPI 1710945118
  Medicare reassignment NPD
• Florida Department of Children and Families

  dba Northeast Florida State Hospital

  • Psychiatric Hospital
  • Macclenny, FL
  • NPI 1013931765
  NPD
• Florida Department of Children and Families

  dba Florida State Hospital

  • Psychiatric Hospital
  • Chattahoochee, FL
  • NPI 1578895470
  NPD

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1881295459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 ELK CLUB RD",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323526492",
            "telephone_number": "850-856-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "city": "CHATTAHOOCHEE",
            "state": "FL",
            "postal_code": "323241107",
            "telephone_number": "850-663-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MARIETTE",
        "middle_name": "ZANDERS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11009858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Department of Children and Families (Florida State Hospital-Unit 31)
• Florida Department of Children and Families (Florida State Hospital)
• Florida State Hospital
• Michae A Ford
• Grant Center Hospital of Ocala Inc. (Family Medical Clinic)
• Tashedra Hadley
• Chelsea Hagen, PSY.D.
• Brian C Ham, ARNP
• James Michael Healy, PH.D.
• Frances L Henry-Bush

• Psychiatric/Mental Health Nurse Practitioner in Chattahoochee, FL
• Providers in Chattahoochee, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.