Organization Active NPI

John M. Gray, MD, PLLC

  • Family Medicine Physician
  • Snoqualmie, WA
National Provider Identifier
1962119735
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHN M. GRAY, MD, PLLC
Doing business as
john m. Gray, MD, PLLC
Practice address
7713 Center Blvd SE Ste 160
Snoqualmie, WA 98065-6309
Phone
(425) 292-3347
Fax
(425) 738-3020
NPI assigned
Nov 1, 2022
Last updated
Feb 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Dr. John Gray, MDNPI 1770663759
Title
Owner
Phone
(206) 484-0053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

7713 Center Blvd SE Ste 160
Snoqualmie, WA 98065-6309

Mailing address

7713 Center Blvd SE Ste 160
Snoqualmie, WA 98065-6309
Phone (425) 292-3347

Other names 1

  • john m. Gray, MD, PLLC Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL elationhealth.com Health Information Exchange (HIE)
CONNECT URL elationhealth.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926000899 WA Part B Supplier - Clinic/Group Practice 6406200443 Receives reassigned benefits from 1 practitioner
Practice locations: Snoqualmie, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2280901John M Gray MD, PLLC7713 Center Blvd SE Ste 160, Snoqualmie, WA 98065Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1962119735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7713 CENTER BLVD SE STE 160",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980656309",
            "telephone_number": "425-292-3347",
            "fax_number": "425-738-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7713 CENTER BLVD SE STE 160",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980656309",
            "telephone_number": "425-292-3347",
            "fax_number": "425-738-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. GRAY, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-484-0053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "elationhealth.com",
            "affiliation": "N",
            "endpointDescription": "practice ehr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7713 Center Blvd SE Ste 160",
            "city": "Snoqualmie",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980656309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "elationhealth.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7713 Center Blvd SE Ste 160",
            "city": "Snoqualmie",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980656309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "john m. Gray, MD, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.