GARY G GRAY (NPI# 1275603672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275603672 |
Entity Type | Individual |
Full Name | GARY G GRAY |
Credential | O.D. |
Practice Address |
2490 N Water St Suite 16 Decatur IL 62526-4251 |
Practice Telephone | 2178754646 |
Practice Fax Number | 2178752870 |
Mailing Telephone | 2178754646 |
Mailing Fax Number | 2178752870 |
Enumeration Date | 2006-11-09 |
Last Update Date | 2007-11-20 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
IL | Eye and Vision Services Providers | |
N | 152WP0200X |
Optometrist Specialization: Pediatrics |
IL | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TN | BCBCS | 4056086 | 01 |
IL | UNITED HEALTHCARE | 6259G | 01 |
IL | DMERC ADMINISTAR | 0159620001 | 01 |
IL | BCBS | 5884008 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922273796 | Gary Brian Gray | Family Medicine | 5890 Valley Rd Ste 200, Birmingham, AL 35235-8669 | 2008-04-23 |
1033242151 | Gary Wynn Gray | Physical Therapist | 1800 W Us 223, Suite 100, Adrian, MI 49221-8439 | 2007-03-14 |
1356485460 | Gary M Gray | Internal Medicine | 300 Pasteur Dr, Rm 211, Mc 5187, Stanford University Medical Center, Stanford, CA 94305-5187 | 2007-02-20 |
1861422495 | Gary Charles Gray | Social Worker | 1681 N Starr Dr, Fayetteville, AR 72701-2936 | 2006-07-03 |
1629028675 | Gary Russel Gray | Counselor | 1101 Belcher Rd S, Suite E, Largo, FL 33771-3356 | 2006-05-11 |
1740590033 | Gary Paul Gray | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2010-10-20 |
1518085281 | Gary J Gray | Preventive Medicine | 6726 Manchester Ave, Saint Louis, MO 63139-3525 | 2007-03-27 |
1780709014 | Gary A. Gray | Counselor | 1212 N California St, Stockton, CA 95202-1552 | 2007-03-19 |
1679688899 | Gary Richard Gray | Family Medicine | 1441 Constitution Blvd, Bldg. 200, Suite 102, Salinas, CA 93906-3100 | 2006-08-20 |
1073555009 | Gary R. Gray | Radiology | 1516 Cotner Ave, Los Angeles, CA 90025-3303 | 2006-06-12 |
Street Address |
2490 N WATER ST SUITE 16 |
City | DECATUR |
State | IL |
Zip Code | 62526-4251 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568491959 | Karen Elena Lee | Psychologist | 2490 N Water St, Suite 9, Decatur, IL 62526-4251 | 2006-06-30 |
1710321229 | Center for Neurobehavioral Disorders, LLC | Clinical Neuropsychologist | 2490 N Water St, Suite 9, Decatur, IL 62526-4251 | 2013-04-26 |
1265677421 | Thomas Kelly Stewart | Social Worker | 2490 N Water St, Suite One, Decatur, IL 62526-4251 | 2008-12-02 |
1245429489 | John Richard Herington | Social Worker | 2490 N Water St, Suite 1, Decatur, IL 62526-4251 | 2007-10-23 |
1295825602 | Jerry R Harrison | Dentist | 2490 N Water St, Suite 11, Decatur, IL 62526-4251 | 2006-10-14 |
1598869588 | John Herington, PC | Social Worker | 2490 N Water St, Suite 1, Decatur, IL 62526-4251 | 2006-09-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
Find all providers in zip 62526 |
Taxonomy Code | 152WC0802X |
Grouping | Eye and Vision Services Providers |
Classification | Optometrist |
Specialization | Corneal and Contact Management |
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609831338 | Grigoriy Solomon | Optometrist | 1781 Clairmont Rd, Decatur, GA 30033-4072 | 2006-04-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912516659 | Northwestern Medical Faculty Foundation | Optometrist | 2701 Patriot Blvd Fl 2, Glenview, IL 60026-8039 | 2020-07-29 |
1225697675 | Park Ridge Vision LLC | Optometrist | 350 S Northwest Hwy Ste 104, Park Ridge, IL 60068-4262 | 2019-06-10 |
1679131213 | Union Eyes, LLC | Optometrist | 15900 W 127th St Ste 221, Lemont, IL 60439-2914 | 2019-05-29 |
1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
1588063572 | Northwestern Medical Faculty Foundation | Optometrist | 259 E. Erie Street, Suite#02-220, Chicago, IL 60611-2661 | 2014-08-15 |
1962734129 | Boyce Family Eye Care, Ltd. | Optometrist | 528 Devon Ave, Park Ridge, IL 60068-4820 | 2010-02-12 |
1558546713 | Halsted Eye Boutique, Inc. | Optometrist | 2852 N Halsted St, Chicago, IL 60657-6531 | 2008-01-07 |
1114119609 | Kapoor Vision Consultants, Ltd | Optometrist | 1221 W Talon Ct, Palatine, IL 60067-1848 | 2007-08-17 |
1649475328 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 223 N Park Ave, Herrin, IL 62948-3149 | 2007-06-20 |
1356559595 | Concept Eye Care, Ltd. | Optometrist | 1605 E 55th St, 1st Flr, Chicago, IL 60615-5803 | 2007-05-20 |
Find all providers with the same taxonomy |
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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.