Kim Gray, MA., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

108179 Issued in TX

Practice address

2117 S Fleishel Ave
Tyler, TX 75701-4440

Phone

(902) 581-5421

NPI assigned

Mar 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521331200000",
    "number": "1912400722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 PRESTONWOOD CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035040",
            "telephone_number": "903-521-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014440",
            "telephone_number": "902-581-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "MA., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-18",
        "last_updated": "2018-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "108179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Graves, LPC, RPT
• Charlotte Gray
• Gerald Duane Gray, D.D.S.
• Hailey Suzanne Gray, PHARMD, RPH
• James Kent Gray, M.D.
• Stacey Gray
• Grayce Nutrition and Wellness, LLC
• Lillie Grayson
• Greater Foundation Foot Clinics East Texas, PLLC
• Richard David Greczanik, D.O.

• Speech-Language Pathologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2018; 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.