Active NPI
Jillianne Grayson, M.D.
- Child & Adolescent Psychiatry Physician
- Huntersville, NC
National Provider Identifier
1962814400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 2021-02687
- Practice address
- 107 Commerce Centre Dr Ste 201
Huntersville, NC 28078-5804 - Phone
- (980) 202-2490
- Fax
- (732) 605-5910
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME134782 | FL | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 2021-02687 | NC | Primary |
Addresses
Primary practice location
107 Commerce Centre Dr Ste 201
Huntersville, NC 28078-5804
Mailing address
107 Commerce Centre Dr Ste 201
Huntersville, NC 28078-5804
Phone (980) 202-2490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME134782 | FL | MD | Psychiatry Physician |
| 2021-02687 | NC | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | 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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670716800000",
"number": "1962814400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 COMMERCE CENTRE DR STE 201",
"city": "HUNTERSVILLE",
"state": "NC",
"postal_code": "280785804",
"telephone_number": "980-202-2490",
"fax_number": "732-605-5910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 COMMERCE CENTRE DR STE 201",
"city": "HUNTERSVILLE",
"state": "NC",
"postal_code": "280785804",
"telephone_number": "980-202-2490",
"fax_number": "732-605-5910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAYSON",
"first_name": "JILLIANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2022-12-11",
"certification_date": "2022-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME134782",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NC",
"license": "2021-02687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.