Active NPI
David Gray
- Specialist
- Commerce City, CO
National Provider Identifier
1922404391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 16825
- Practice address
- 13635 East 104TH Ave.
Suite 150
Commerce City, CO 80022 - Phone
- (303) 589-5116
- NPI assigned
- Nov 13, 2014
- Last updated
- Nov 13, 2014
- Sex
- Male
- 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 | 16825 | CO | Primary |
Addresses
Primary practice location
13635 East 104TH Ave.
Suite 150
Commerce City, CO 80022
Mailing address
13635 East 104TH Ave.
Suite 150
Commerce City, CO 80022
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 |
|---|---|---|---|
| 16825 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415836800000",
"number": "1922404391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13635 EAST 104TH AVE.",
"address_2": "SUITE 150",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "80022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13635 EAST 104TH AVE.",
"address_2": "SUITE 150",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "80022",
"telephone_number": "303-589-5116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2014-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "16825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.