Individual provider Active NPI

Jessica R Gray, FNP-BC

  • Family Nurse Practitioner
  • Mayfield Heights, OH
National Provider Identifier
1881555720
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0040859 Issued in OH
Practice address
1284 Som Center Rd Ste 368
Mayfield Heights, OH 44124-2048
Phone
(216) 916-7771
Fax
(216) 916-7779
NPI assigned
Nov 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0040859 OH Primary

Addresses

Primary practice location

1284 Som Center Rd Ste 368
Mayfield Heights, OH 44124-2048

Mailing address

1284 Som Center Rd Ste 368
Mayfield Heights, OH 44124-2048
Phone (216) 916-7771

Other practice location 1

269 Portland Way S
Galion, OH 44833-2312
Phone (216) 916-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20251217002446 OH Practitioner - Nurse Practitioner 7214422211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

229 W Main Cross St
Suite 58
Findlay, OH 45840-3301

PO Box
Suite 1071
Perrysburg, OH 43552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0040859OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Key Clinics, LLC CurrentSince Nov 20, 2025 Accepting new patients
Key Clinics LLC CurrentSince Nov 20, 2025 Accepting new patients

Locations

629 N Sandusky Ave
Bucyrus, OH 44820
Phone (419) 562-4677

269 Portland Way S
Galion, OH 44833
Phone (419) 468-4841

269 Portland Way S
Lbby
Galion, OH 44833
Phone (419) 775-7440

1284 Som Center Rd
Mayfield Heights, OH 44124
Phone (888) 774-7773

715 Richland Mall
Ontario, OH 44906
Phone (419) 462-4547

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.

NPI Registry JSON

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

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1881555720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 SOM CENTER RD STE 368",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242048",
            "telephone_number": "216-916-7771",
            "fax_number": "216-916-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 SOM CENTER RD STE 368",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242048",
            "telephone_number": "216-916-7771",
            "fax_number": "216-916-7779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Portland Way S",
            "address_purpose": "LOCATION",
            "city": "Galion",
            "state": "OH",
            "postal_code": "448332312",
            "country_code": "US",
            "telephone_number": "216-916-7771",
            "fax_number": "216-916-7779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0040859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Heights, OH

Sources for this page

Verify at the official NPI Registry.