Individual provider Active NPI

Sara Gray, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1982072922
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9316482 Issued in FL
Practice address
5707 N 22ND St
Tampa, FL 33610-4350
Phone
(813) 272-2244
NPI assigned
Sep 8, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9316482 FL Primary

Addresses

Primary practice location

5707 N 22ND St
Tampa, FL 33610-4350

Mailing address

5707 N 22ND St
Tampa, FL 33610-4350
Phone (813) 272-2244

Other practice location 1

100 Main St
Ste 203
Safety Harbor, FL 34695-3657
Phone (727) 799-4150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008001041 FL Practitioner - Nurse Practitioner 8022326214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ibis Healthcare IncGroup PAC ID 2769469204, 24 clinicians

Practice addresses (Care Compare)

5707 - N 22ND St
Tampa, FL 33610-4350
Phone (813) 239-8069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9316482FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Healthcare Options, Inc. CurrentSince Sep 10, 2015 Accepting new patients
Ibis Healthcare Inc CurrentSince Sep 24, 2017 Accepting new patients
Ibis Healthcare Inc CurrentSince Sep 24, 2017 Accepting new patients
Kolettis Krew LLC PastSince Sep 10, 2015 Accepting new patients

Locations

11300 US Highway 19 N
Clearwater, FL 33764
Phone (727) 541-2646

100 Main St
Ste 203
Safety Harbor, FL 34695
Phone (727) 738-8410

2212 E Henry Ave
Tampa, FL 33610
Phone (386) 336-0793

5707 N 22nd St
Tampa, FL 33610
Phone (813) 272-2244

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982072922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-272-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-272-2244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Main St",
            "address_2": "STE 203",
            "address_purpose": "LOCATION",
            "city": "Safety Harbor",
            "state": "FL",
            "postal_code": "346953657",
            "country_code": "US",
            "telephone_number": "727-799-4150",
            "fax_number": "727-796-1845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SARA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9316482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.