Ashley Russell-Gray, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12032 Issued in NC

Practice address

116 Country Club Dr
Fayetteville, NC 28301-7604

Phone

(910) 488-0157

NPI assigned

Feb 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ashley Lawson Russell-Gray Other name

Medicare fee-for-service enrollment

Enrolled in NC, MA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Boston Neurobehavioral Associates, LLC

  • Psychiatry Physician
  • New Bedford, MA
  • NPI 1558415307
  Medicare reassignment

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1982350435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 LITTLE BRIDGE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283113069",
            "telephone_number": "215-859-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 COUNTRY CLUB DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017604",
            "telephone_number": "910-488-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL-GRAY",
        "first_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "RUSSELL-GRAY",
            "middle_name": "LAWSON",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Johnathon Raymond Rush, LCSW
• Sharon Ann Rush, NNP
• Victoria Charlene Rush, LPC
• Tabitha Lynn Russ, MSW, LCSWA
• Jasmyne Russell-Dicker, CPPS
• Laurie Rae Russell-Peabody, LCSWA, MSW, BSW
• Cynthia Reed Russell, NNP
• Fatia A Russell
• Kim Marie Russell, RRT
• Kristin Erryn Russell, PA-C

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.

Verify at the official NPI Registry.