Theresa Gray, MHS PA-C
Individual provider Active NPI Physician Assistant · Winston Salem, NC
NPI 1891959102 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1891959102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-02992 (NC)
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-6583 - Phone
- (336) 716-6674
- NPI assigned
- Jul 16, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DRX High Point PLLC
Practice addresses (Care Compare)
1231 Eastchester Dr
High Point, NC 27265-3102
Phone (336) 884-4050
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 |
|---|---|---|---|---|
| I20111222000518 | NC | Practitioner - Physician Assistant | 8820264898 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goshen Medical Center Incorporated | Current |
Accepting new patients | |
| Wake Forest University Health Sciences | Current |
Accepting new patients | |
| Goshen Medical Center Incorporated | Current | Accepting new patients | |
| Goshen Medical Center, Incorporated | Current |
Accepting new patients | |
| Outer Banks Professional Services, LLC | Current |
Accepting new patients |
Locations
1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000
444 SW Center St
Faison, NC 28341
Phone (910) 267-0421
402 W King St
King, NC 27021
Phone (336) 529-4304
5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- tgray@goshenmedical.cloudcraftdirect.com
- tgray441403@direct.novanthealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 0010-02992 | NC | Yes |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-6583
Mailing address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-6674
Other practice location 1
9604 Holly Point Dr
Huntersville, NC 28078-4913
Phone (989) 345-8126
Other practice location 2
8110 Healthcare Loop
Charlotte, NC 28215
Phone (704) 316-2310
Other practice location 3
19485 Old Jetton Rd Ste 100
Cornelius, NC 28031-6583
Phone (704) 384-1775
Other practice location 4
130 Plantation Ridge Dr Ste 100
Mooresville, NC 28117-9239
Phone (704) 316-1635
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tgray441403@direct.novanthealth.org |
Other providers in Winston Salem, NC
- Latonya Shari Gray
- Lawrence Dennis Gray Jr.
- Samuel Bemiss Gray
- Shaketha Acquinetta Gray
- Sheila J Gray
- Andrea Helen Graziano
- Kelsey E Graziose
- Veronika Grechana
- Anna Green
- Carla Jay Green
All providers in Winston Salem, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. 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.