Annemarie Catherine Gray, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-29893 Issued in IN

Practice address

3730 Edison Lakes Pkwy
Mishawaka, IN 46545-3424

Phone

(574) 387-4313

Fax

(574) 204-2868

NPI assigned

Jan 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Annemarie Root Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1902370729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 TOUBY PIKE STE B",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469012573",
            "telephone_number": "765-628-7400",
            "fax_number": "765-450-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453424",
            "telephone_number": "574-387-4313",
            "fax_number": "574-204-2868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Park Place Cir",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465453511",
            "country_code": "US",
            "telephone_number": "574-387-4313",
            "fax_number": "574-204-2868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANNEMARIE",
        "middle_name": "CATHERINE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-18-29893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNEMARIE",
            "last_name": "ROOT",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Grace Gouker, PA-C
• Kayla Gowen
• Mary Evelyn Graber, M.D.
• Michael F Grantham, MD
• Kristin Grathen, RN
• Christie Gray
• Candice Marie Greathouse
• Silas Greathouse
• Ashley Griffin
• Russell L Griffing, D.M.D.

• Behavior Analyst in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.