DR. JERRY MCNICOLL GRAY (NPI# 1477761195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477761195 |
| Entity Type | Individual |
| Full Name | DR. JERRY MCNICOLL GRAY |
| Credential | MD |
| Practice Address |
145 Columbia Ave Holland MI 49423-2987 |
| Practice Telephone | 7342553884 |
| Practice Fax Number | 7349717079 |
| Mailing Telephone | 7342553884 |
| Mailing Fax Number | 7349717079 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2019-08-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZH0000X |
Pathology Specialization: Hematology |
4301023740 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PHYSICIAN LICENSE | 4301023740 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104818756 | Jerry L Gray | Internal Medicine | 1599 Somerset Ave, Ste #1, Windber, PA 15963 | 2005-08-19 |
| 1518276559 | Jerry Wayne Gray | Dental Hygienist | 6601 S Rural Rd, Tempe, AZ 85283-3747 | 2010-09-24 |
| 1881600732 | Jerry L Gray | Emergency Medicine | 1190 Waianuenue Ave, Hilo, HI 96720-2020 | 2006-07-31 |
| Street Address |
145 COLUMBIA AVE |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-2987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568412690 | Ccrc Opco - Holland, LLC | Skilled Nursing Facility | 145 Columbia Ave, Holland, MI 49423-2981 | 2006-05-11 |
| 1245644509 | Ccrc Opco - Holland, LLC | Skilled Nursing Facility | 145 Columbia Ave, Holland, MI 49423-2981 | 2014-06-16 |
| 1023328697 | Spectrum Health Primary Care Partners | Internal Medicine | 145 Columbia Ave, Holland, MI 49423-2981 | 2010-10-18 |
| 1336450071 | George Jay Hoekstra | Family Medicine | 145 Columbia Ave, # 209, Holland, MI 49423-2983 | 2010-06-28 |
| 1962660001 | Michigan Medical Patient Care | Podiatrist | 145 Columbia Ave, Holland, MI 49423-2981 | 2008-05-27 |
| 1396783858 | Arc Therapy Services LLC | Clinic/Center | 145 Columbia Ave, Holland, MI 49423-2981 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996714 | Ella Rose Marx | Social Worker | 412 Century Lane, Holland, MI 49423 | 2019-08-02 |
| 1245720424 | Amanda Ann Allen | Behavior Technician | 165 Sorrento Drive, Holland, MI 49423 | 2018-05-14 |
| 1588194237 | Emily Amila Geurink | Physical Therapy Assistant | 4037 43rd St, Holland, MI 49423 | 2017-06-15 |
| 1285081737 | Kara Draayer | Nurse Anesthetist, Certified Registered | 25 W 8th St Ste 200, Holland, MI 49423 | 2016-05-14 |
| 1851776413 | Sara Ty | Occupational Therapist | 789 South Meadow Court, Holland, MI 49423 | 2015-07-24 |
| 1508243056 | Andrew Peasley | Chiropractor | 436 Century Ln., Holland, MI 49423 | 2015-05-05 |
| 1437536497 | Deborah Donnelly | Physical Therapy Assistant | 1221 16th Street, Holland, MI 49423 | 2015-04-29 |
| 1366846024 | John Nguyen | Pharmacist | 747 E 16th St, Holland, MI 49423 | 2014-10-09 |
| 1003257817 | Courtney Young | Social Worker | 96 W 15 Street Midtown Center- Arbor Circle, Holland, MI 49423 | 2013-07-09 |
| 1689014391 | Jason Pettet | Acupuncturist | 500 West 17th St., Holland, MI 49423 | 2013-06-26 |
| Find all providers in zip 49423 | ||||
| Taxonomy Code | 207ZH0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Hematology |
| A hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the knowledge and technical skills essential for the laboratory diagnosis of anemias, leukemias, lymphomas, bleeding disorders and blood clotting disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pathology. The Certification is NO longer provided. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902231848 | Catherine I Socec | Pathology | 4201 Saint Antoine St Ste 3e-1, Detroit, MI 48201-2153 | 2013-09-11 |
| 1508164021 | Tapan Mahendra Bhavsar | Pathology | 4201 Saint Antoine St # 2s-13, Detroit, MI 48201-2153 | 2011-03-08 |
| 1306952510 | Rajan Dewar | Pathology | 500 Kirts Blvd Ste 100, Troy, MI 48084 | 2006-08-21 |
| 1740240100 | Joan C. Mattson | Pathology | 15344 Club Course Dr, Bath, MI 48808-8797 | 2006-03-27 |
| 1427413954 | Jie Yan | Pathology | 2799 W Grand Blvd, Detroit, MI 48202 | 2015-12-29 |
| 1467834523 | Lauren Michele Stanoszek | Pathology | 1301 Catherine Street, 4232 Med Sci I, Ann Arbor, MI 48109-5602 | 2015-06-25 |
| 1356723415 | Steven Carl Weindorf | Pathology | 1105 Sixth St, Traverse City, MI 49684-2345 | 2015-06-25 |
| 1306266804 | Yi Wang | Pathology | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2014-04-23 |
| 1932403482 | Rashi Singhal Gupta | Pathology | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2010-12-26 |
| 1013232859 | Winston Yuhsien Lee | Pathology | 1500 East Medical Center Dr, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2010-04-05 |
| 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.