Stefanie Lea Gray, APRN-BC
Individual provider Active NPI Family Nurse Practitioner · Martin, TN
NPI 1891908117 · NPPES record last updated Jun 28, 2010
Key facts
- NPI
- 1891908117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 12648 (TN)
- Practice address
- 117 Kennedy Dr
Martin, TN 38237-3309 - Phone
- (731) 587-9511
- Fax
- (731) 587-0785
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Medical Clinic PLLC
Bane Medical Management LLC
Practice addresses (Care Compare)
100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000
108 Courtright Rd
Martin, TN 38237-1607
Phone (615) 988-1571
1705 W Reelfoot Ave
Union City, TN 38261-5569
Phone (855) 632-3278
415 S Lindell St
Martin, TN 38237-2442
Phone (731) 281-4292
4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321
750 US Hwy 51 Byp W
Dyersburg, TN 38024-1950
Phone (931) 253-1110
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070807000214 | TN | Practitioner - Nurse Practitioner | 9830280791 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Bane Medical Management LLC | Current |
Accepting new patients | |
| Emergency Coverage Services, PC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Geriatric Essentials, PC | Past | Accepting new patients |
Locations
7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
108 Courtright Rd
Martin, TN 38237
Phone (731) 281-4183
415 S Lindell St
Martin, TN 38237
Phone (731) 255-5138
435 2nd St
Newport, TN 37821
Phone (423) 625-2200
Interoperability endpoints
- stefanie.gray.1@32899.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 12648 | TN | Yes |
Addresses
Primary practice location
117 Kennedy Dr
Martin, TN 38237-3309
Mailing address
117 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-9511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4157106 | Other | TN | BLUE CROSS BLUE SHIELD |
| 3341164 | Medicaid | TN |
Other providers in Martin, TN
- Generations Health Assoc.,Inc.Dba Generations Mental Health Center
- Generations Health Association
- Generations- Gaithers, Inc.
- Jacqueline Cultra Gilliam
- Valerie Anna Gilliland
- Ashley Lynn Hall
- Rebecca Diane Hall
- David Martin Hamlin
- Happy Teeth Pediatric Dentistry
- Joycelyn Hardin
All providers in Martin, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.