Organization Active NPI

Dr. Phillip H. Gray, P.a.

  • Optometrist
  • Iuka, MS
National Provider Identifier
1891890794
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
94020 Issued in MS
Legal business name
DR. PHILLIP H. GRAY, P.A.
Practice address
105 S Fulton St
Iuka, MS 38852-2328
Phone
(662) 423-3785
Fax
(662) 423-2849
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Dr. Phillip Adam GrayNPI 1518980051
Title
Owner
Phone
(662) 423-3785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 94020 MS Primary

Addresses

Primary practice location

105 S Fulton St
Iuka, MS 38852-2328

Mailing address

105 S Fulton St
Iuka, MS 38852-2328
Phone (662) 423-3785

Other identifiers 1

IdentifierTypeStateIssuer
06673726MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060920000430 MS Part B Supplier - Clinic/Group Practice 0244235588 Receives reassigned benefits from 3 practitioners
Practice locations: Iuka, MS
O20100930000143 MS DME Supplier - Physician - Optometrist 0244235588 Practice locations: Iuka, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dr. Phillip H. Gray, P.a.105 S Fulton St, Iuka, MS 38852-2328(662) 423-3785 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jun 30, 1981

National Provider Directory

National Provider Directory

Locations

105 S Fulton St
Iuka, MS 38852
Phone (601) 423-3300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1891890794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S FULTON ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388522328",
            "telephone_number": "662-423-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S FULTON ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388522328",
            "telephone_number": "662-423-3785",
            "fax_number": "662-423-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PHILLIP H. GRAY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-423-3785",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "94020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06673726",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iuka, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.