Debra Anna Gray, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11540-24 Issued in WI

Practice address

4912 Annabelle CT
Weston, WI 54476-4268

Phone

(719) 645-9455

Fax

(866) 736-4757

NPI assigned

Apr 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Diagnostic & Treatment Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Weston, WI
  • NPI 1659385540
  NPD (past)
• Diagnostic & Treatment Center, LLC

  • Clinical Medical Laboratory
  • Weston, WI
  • NPI 1740294636
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1952363582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 ANNABELLE CT",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764268",
            "telephone_number": "719-645-9455",
            "fax_number": "866-736-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 ANNABELLE CT",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764268",
            "telephone_number": "719-645-9455",
            "fax_number": "866-736-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DEBRA",
        "middle_name": "ANNA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8870",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11540-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80982751",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cally F Gordon-Haessly, PA-C
• Ryan A Gossett, MD
• Lisa Gouthro, APSW
• Robert Vincent Gouthro Jr., M.D.
• Dylan Michael Graff, PA-C
• Gregory Cowan LLC
• Gregory Wayne Grzesik, D.O.
• Holly Guigauri
• Tracey M Gusman, LPC, SAC,NCC
• Carina Lea Hafner, OT

• Physical Therapist in Weston, WI
• Providers in Weston, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.