Jay Patrick Grayson, CSFA, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

13-456 Issued in TN

Practice address

114 E McGuire St
Bell Buckle, TN 37020-6052

Phone

(931) 205-2753

NPI assigned

Aug 28, 2016

Last updated

Aug 28, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1902352172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802",
            "city": "LYNCHBURG",
            "state": "TN",
            "postal_code": "373520802",
            "telephone_number": "931-205-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E MCGUIRE ST",
            "city": "BELL BUCKLE",
            "state": "TN",
            "postal_code": "370206052",
            "telephone_number": "931-205-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "JAY",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "CSFA, SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TN",
            "license": "13-456",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TN",
            "license": "103596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bell Buckle Family Medical Clinic
• Brittany Anne Clark, PMHNP
• Ana Mercedes Griggs, PA-C
• Priscilla Handy, LPN
• Jessica Hester, ATC, LAT
• Cameron Hix
• Katelyn Jarrell

• Surgical Assistant in Bell Buckle, TN
• Providers in Bell Buckle, TN by specialty
• Surgical Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.