MS. TANDRA RENEA GRAY (NPI# 1528587201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528587201 |
| Entity Type | Individual |
| Full Name | MS. TANDRA RENEA GRAY |
| Practice Address |
2405 Stanford Rd Apt 204 Panama City FL 32405-3556 |
| Practice Telephone | (850) 832-7806 |
| Mailing Telephone | 8508327806 |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2405 STANFORD RD APT 204 |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-3556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796275 | Mireille Alexis | Prosthetist | 4376 Fl-7, Coral Springs, FL 33073 | 2020-10-08 |
| 1588279434 | Kourtney James | Prosthetist | 715 Lori Dr Apt 304, Palm Springs, FL 33461-7104 | 2020-09-08 |
| 1750910790 | Gabriela Jamur | Prosthetist | 11308 Bonita Beach Rd Se Ste 105-a, Bonita Springs, FL 34135-5912 | 2020-04-02 |
| 1013543701 | Kateau Cerisme | Prosthetist | 320 N Magnolia Ave, Orlando, FL 32801-1624 | 2020-03-13 |
| 1780217174 | Amber Baker | Prosthetist | 1340 Naples Cir Apt 309, Rockledge, FL 32955-2577 | 2020-02-13 |
| 1992336192 | Antakeisha Lavonte Hepburn | Prosthetist | 2326 Nw 51st St, Miami, FL 33142-3677 | 2020-01-28 |
| 1164067211 | Rayna K Bradley | Prosthetist | 148 Lake Ave, Maitland, FL 32751-6424 | 2019-11-13 |
| 1376001982 | Kerryann Williams | Prosthetist | 6515 Nw 1st St, Margate, FL 33063-5101 | 2019-03-04 |
| 1528526126 | Latoya Patrick | Prosthetist | 11361 Sheffield Rd, Spring Hill, FL 34608-2260 | 2019-03-04 |
| 1275091878 | Debbie Denizard | Prosthetist | 9560 Lem Turner Rd, Jacksonville, FL 32208-7501 | 2019-03-04 |
| Find all providers with the same taxonomy | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
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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.