Laura Rose Gray, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1841 Issued in OK

Practice address

6839 S Canton Ave
Tulsa, OK 74136-3402

Phone

(918) 494-0612

Fax

(918) 481-5170

NPI assigned

Jun 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Laura Rose Nicholson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1952539926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LAURA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "NICHOLSON",
            "middle_name": "ROSE",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Nicole Gray, PHARMD
• Gena C. Gray, M.D.
• Greg H Gray, DO
• Jenifer Gray, LPC-U/S
• Jessica Renae Gray
• Megan E Gray, MSPT
• Melissa R Gray, PT
• Morgan Gray, DO
• Presley Gray, PA
• Rachel Gray

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.