SHANNON GRAY (NPI# 1245553502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245553502 |
| Entity Type | Organization |
| Organization Name | SHANNON GRAY |
| Other Organization Name | VISTA MEDICAL GROUP |
| Practice Address |
1111 S Stapley Dr Suite 111 Mesa AZ 85204-5059 |
| Mailing Address |
212 W Superstition Blvd Suite 101 Apache Junction AZ 85120-4127 |
| Practice Telephone | 4803981220 |
| Practice Fax Number | 4803981230 |
| Mailing Telephone | 4809834200 |
| Mailing Fax Number | 4809834317 |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2010-03-01 |
| Authorized Official Name | MISS SHANNON GRAY (ADMINISTRATOR/OWNER) |
| Authorized Official Telephone | 4809834200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 36286 | AZ | Other Service Providers |
| Other Name | Type Code |
|---|---|
| VISTA MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558365536 | Shannon Gray | Clinic/Center | 605 N Gilbert Rd, Mesa, AZ 85203-6629 | 2005-06-08 |
| Street Address |
1111 S STAPLEY DR SUITE 111 |
| City | MESA |
| State | AZ |
| Zip Code | 85204-5059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568433787 | Jennifer Elhabiby | Optometrist | 1111 S Stapley Dr, Mesa, AZ 85204-5015 | 2006-01-27 |
| 1063013506 | Geoffrey B Carr | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-11-02 |
| 1639777220 | Mary E Pals | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-10-15 |
| 1467050195 | Linsey M Mettenbrink | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-10-14 |
| 1578198479 | Adrienne Rabick | Counselor | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-03-11 |
| 1972135390 | Terros, Inc. | Community/Behavioral Health | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-02-05 |
| 1366072399 | Jennifer L Spaude | Social Worker | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2020-01-17 |
| 1124664362 | Diana M Kirby | Social Worker | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2019-11-22 |
| 1376189894 | Amanda M Chavez | Social Worker | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2019-11-19 |
| 1720555030 | Terros Inc | Clinic/Center | 1111 S Stapley Dr, Mesa, AZ 85204-5059 | 2018-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942810833 | Modern Sports Medicine LLC | Specialist | 6242 E Arbor Ave Unit 1, Mesa, AZ 85206-1309 | 2020-08-05 |
| 1366920910 | Haleys Designer Wigs | Specialist | 6017 E Mckellips Rd Ste 109, Mesa, AZ 85215-2824 | 2018-08-04 |
| 1831604990 | Shanna Kay Parker | Specialist | 1055 W Baseline Rd Apt 1049, Mesa, AZ 85210-9504 | 2017-12-11 |
| 1558884866 | Affiliated Pro Monitoring, LLC | Specialist | 6424 E Broadway Rd Ste 120, Mesa, AZ 85206-1750 | 2017-07-18 |
| 1861863011 | Christina Wright | Specialist | 11033 E Abilene Ave, Mesa, AZ 85208-8645 | 2015-10-14 |
| 1821465584 | Arizona Medical Associates Inc | Specialist | 1301 South Rismon Road, Mesa, AZ 85209-3767 | 2015-08-28 |
| 1174926794 | Breast Ink Plc | Specialist | 2321 S Alta Vista Cir, Mesa, AZ 85202-6474 | 2014-09-28 |
| 1780957985 | Clear Choice Physicians, LLC | Specialist | 6328 E Brown Rd Ste 106, Mesa, AZ 85205-4841 | 2012-02-17 |
| 1538445812 | Modocurogyn, Pllc | Specialist | 6632 E. Baseline Rd, Ste 101, Mesa, AZ 85206 | 2011-10-31 |
| 1508140005 | Janice A Spears | Specialist | 1840 W Emelita Ave, #1144, Mesa, AZ 85202-4035 | 2011-10-03 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.