Active NPI
Sandra L Gray, PHARMACIST
- Specialist
- Jackson, MI
National Provider Identifier
1922156033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 5302030049
- Practice address
- 5880 S Jackson Rd
Jackson, MI 49201-8313 - Phone
- (517) 414-6695
- NPI assigned
- Jan 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5302030049 | MI | Primary |
Addresses
Primary practice location
5880 S Jackson Rd
Jackson, MI 49201-8313
Mailing address
5880 S Jackson Rd
Jackson, MI 49201-8313
Phone (517) 414-6695
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302030049 | MI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922156033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5880 S JACKSON RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492018313",
"telephone_number": "517-414-6695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5880 S JACKSON RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492018313",
"telephone_number": "517-414-6695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "SANDRA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "5302030049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
- Angela Marie Grantham, OTRL, CHT
- Benjamin K Grapentine
- Madeleine Lee Grauer, FNP-BC
- Lauren Elizabeth Gravelyn
- Brytney Merrie Graves
- Theresa Ann Gray, RN
- Great Lakes Brain and Spine Institute PC
- Great Lakes Comprehensive Psychological Services
- Great Lakes Home Health Services, Inc.
- Great Lakes Home Health Services, Inc. (Elara Caring)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.