Individual provider Active NPI

Noel W Gray, DC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1972025831
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1397 Issued in HI
Practice address
1807 University Blvd S
Jacksonville, FL 32216-8930
Phone
(904) 721-5464
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1397 HI Primary

Addresses

Primary practice location

1807 University Blvd S
Jacksonville, FL 32216-8930

Mailing address

1807 University Blvd S
Jacksonville, FL 32216-8930
Phone (904) 721-5464

Other practice location 1

95-023 Waihau St Apt E241
Mililani, HI 96789-3384
Phone (315) 573-4461

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214001646 FL Practitioner - Chiropractic 1759646805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
R D Rice Chiropractic PAGroup PAC ID 2668642307, 2 clinicians

Practice addresses (Care Compare)

2888 S 8TH St
Fernandina Beach, FL 32034-4462
Phone (904) 321-0002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1397HIMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R D Rice Chiropractic PA Chiropractor CurrentSince Jan 1, 2024 Accepting new patients
Coastline Chiropractic Hawaii LLC Chiropractor CurrentSince Oct 20, 2019 Accepting new patients
River Hills Chiropractic Clinic Inc CurrentSince Aug 2, 2020 Accepting new patients
Amelia Chiropractic Clinic Chiropractor PastSince Jan 1, 2024 Accepting new patients

Locations

2888 S 8th St
Fernandina Beach, FL 32034
Phone (904) 321-0002

1807 University Blvd S
Jacksonville, FL 32216
Phone (904) 721-5464

Organizations & group practices 4

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1972025831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168930",
            "telephone_number": "904-721-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168930",
            "telephone_number": "904-721-5464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95-023 Waihau St Apt E241",
            "address_purpose": "LOCATION",
            "city": "Mililani",
            "state": "HI",
            "postal_code": "967893384",
            "country_code": "US",
            "telephone_number": "315-573-4461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "NOEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "1397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.