Individual provider Active NPI

Caron J Gray, M.D.

  • Obstetrics & Gynecology Physician
  • Omaha, NE
National Provider Identifier
1922119452
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21443 Issued in NE
Practice address
601 N 30TH St
Suite 4700
Omaha, NE 68131-2128
Phone
(402) 717-0909
Fax
(402) 717-6069
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21443 NE Primary

Addresses

Primary practice location

601 N 30TH St
Suite 4700
Omaha, NE 68131-2128

Mailing address

PO Box 642117
Omaha, NE 68164-8117
Phone (402) 398-6254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071116000145 NE Practitioner - Obstetrics/Gynecology 7911095484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northwestern University Feinberg Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

2412 Cuming St
Suite 200
Omaha, NE 68131-1601
Phone (402) 717-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Sep 1, 2012 Accepting new patients
Creighton University Past Accepting new patients
Creighton University Obstetrics & Gynecology Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

4920 S 30th St
Ste 103
Omaha, NE 68107

2412 Cuming St
Ste 200
Omaha, NE 68131
Phone (402) 717-0380

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

2514 S 119th St
Omaha, NE 68144
Phone (402) 330-5913

Interoperability endpoints

  • Direct secure messaging: caron.gray.1@23757.direct.athenahealth.com
  • Direct secure messaging: caron.gray.p1@direct.oneworldomaha.nextgenshare.com
  • Direct secure messaging: cgray45788@achce.catholichealth.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1922119452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642117",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681648117",
            "telephone_number": "402-398-6254",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "address_2": "SUITE 4700",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312128",
            "telephone_number": "402-717-0909",
            "fax_number": "402-717-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CARON",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "21443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.