Individual provider Active NPI

Curtis Eric Grey, M.D.

  • Family Medicine Physician
  • Athens, TX
National Provider Identifier
1962404756
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L6920 Issued in TX
Practice address
115 Medical Cir
Suite 100F
Athens, TX 75751-9004
Phone
(903) 675-5741
Fax
(903) 675-5677
NPI assigned
Aug 11, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L6920 TX Primary

Addresses

Primary practice location

115 Medical Cir
Suite 100F
Athens, TX 75751-9004

Mailing address

115 Medical Cir
Suite 100F
Athens, TX 75751-9004
Phone (903) 675-5741

Other identifiers 2

IdentifierTypeStateIssuer
162278902MedicaidTX
162278901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031219000764 TX Practitioner - Family Practice 7618875295 Practice locations: Athens, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L6920TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Physicians Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1962404756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR",
            "address_2": "SUITE 100F",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-675-5741",
            "fax_number": "903-675-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR",
            "address_2": "SUITE 100F",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-675-5741",
            "fax_number": "903-675-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "CURTIS",
        "middle_name": "ERIC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-12-27",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L6920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162278902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162278901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

Verify at the official NPI Registry.