Individual provider Active NPI

Michelle Anne Gray, MS, OTR/L, CLT

  • Hand Occupational Therapist
  • Chattanooga, TN
National Provider Identifier
1932407426
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
5378 Issued in TN
Practice address
1608 Gunbarrel Rd
Ste 103
Chattanooga, TN 37421-7197
Phone
(423) 892-8070
Fax
(423) 893-9891
NPI assigned
Mar 7, 2011
Last updated
Mar 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 5378 TN Primary
Hand Occupational Therapist 225XH1200X OT 12872 CA

Addresses

Primary practice location

1608 Gunbarrel Rd
Ste 103
Chattanooga, TN 37421-7197

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other names 1

  • Michelle Iovannisci Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200330001343 NY Practitioner - Occupational Therapist in Private Practice 4486831815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
015234NYMDPsychologist
OT 12872CAMDHand Occupational Therapist
5378TNMDPhysician Assistant
12872CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Hand and Physical Therapy Inc Hand CurrentSince Jan 5, 2013 Accepting new patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Jan 21, 2020 Accepting new patients
California Hand and Physical Therapy Inc PastSince Jan 5, 2013 Accepting new patients
PT Hawaii, Inc. PastSince Apr 23, 2015 Accepting new patients

Locations

2001 Solar Dr
Ste 150
Oxnard, CA 93036
Phone (805) 604-1924

2001 Solar Dr
Ste 180
Oxnard, CA 93036
Phone (805) 604-1924

425 Lombard St
Thousand Oaks, CA 91360
Phone (805) 494-4145

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1932407426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 GUNBARREL RD",
            "address_2": "STE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217197",
            "telephone_number": "423-892-8070",
            "fax_number": "423-893-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHELLE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "TN",
            "license": "5378",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT 12872",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "IOVANNISCI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.