Active NPI
Carol Gray, PHYSIOLOGST.,H.COACH
- Exercise & Sports Psychologist
- Roxboro, NC
National Provider Identifier
1962952010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exercise & Sports Psychologist
- Practice address
- 910 N Madison Blvd
Roxboro, NC 27573-4573 - Phone
- (336) 322-8000
- NPI assigned
- Oct 12, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exercise & Sports Psychologist | 103TE1100X | Primary |
Addresses
Primary practice location
910 N Madison Blvd
Roxboro, NC 27573-4573
Mailing address
6687 Burlington Rd
Hurdle Mills, NC 27541-9319
Phone (336) 747-0528
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T49071 | Other | AMERICAN COUNCIL ON EXERCISE | |
| BS DEGREE | Other | NC | APPALCHIAN STATE UNIVERSITY |
| 14488787 | Other | NC | AMERICAN RED CROSS |
Other names 1
- Mrs. Carol Gray Miller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476230400000",
"number": "1962952010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6687 BURLINGTON RD",
"city": "HURDLE MILLS",
"state": "NC",
"postal_code": "275419319",
"telephone_number": "336-747-0528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 N MADISON BLVD",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275734573",
"telephone_number": "336-322-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "CAROL",
"name_prefix": "Ms.",
"credential": "PHYSIOLOGST.,H.COACH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-12",
"last_updated": "2016-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN COUNCIL ON EXERCISE",
"identifier": "T49071",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APPALCHIAN STATE UNIVERSITY",
"identifier": "BS DEGREE",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN RED CROSS",
"identifier": "14488787",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROL",
"last_name": "MILLER",
"middle_name": "GRAY",
"prefix": "MRS.",
"credential": "CPT,CWHC IN PROGRESS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Roxboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.