Kimberly Gray, MBA, MSS, MLSP, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020332 Issued in PA

Practice address

6331 Germantown Ave # 2
Philadelphia, PA 19144-1907

Phone

(215) 450-1869

NPI assigned

Jan 23, 2019

Last updated

Sep 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Supportive Care of Pennsylvania LLCGroup PAC ID 0143521211, 91 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

76.62

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73304
• FHIR API: https://fhir4.healow.com/fhir/r4/CHJCDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Supportive Care of Pennsylvania LLC

  • Clinical Psychologist
  • Monsey, NY
  • NPI 1174992275

  PA

  Medicare reassignment Care Compare group
• Sayre Health Center

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1831209113
  Medicare reassignment NPD
• Change Point Behavioral Health LLC

  • Mental Health Counselor
  • Bala Cynwyd, PA
  • NPI 1659969459
  NPD Authorized official

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1972067999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 GERMANTOWN AVE # 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441907",
            "telephone_number": "215-450-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 GERMANTOWN AVE # 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441907",
            "telephone_number": "215-450-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KIMBERLY",
        "credential": "MBA, MSS, MLSP, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilary Margaret Gray, DO
• Holly Gray
• Jamilah Gray
• Jonathan Gray
• Judah Gray, MD
• Lauren Michelle Gray, LSW
• Lauryn Gray
• Madeline Alyssa Gray, LCSW
• Michael Patrick Gray, PH.D.
• Patrick Gray, MD

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.
• 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.