DR. BRADLEY WAYNE GRAY (NPI# 1851785976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851785976 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY WAYNE GRAY |
| Credential | M.D. |
| Practice Address |
2170 South Ave South Lake Tahoe CA 96150-7026 |
| Mailing Address |
1808 W Main St Russellville AR 72801-2724 |
| Practice Telephone | 5305413420 |
| Mailing Telephone | 4799644178 |
| Mailing Fax Number | 4799645910 |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2020-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | E-10753 | AR | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | E-10753 | AR | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1125 N College Ave, Fayetteville, AR 727031908 | 4796012015 | |
| 1808 W Main St, Russellville, AR 72801 | 4799644178 | 4799645910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912126160 | Bradley Gray | Dentist | 17746 Sun Park Dr, Westfield, IN 46074-9536 | 2007-04-25 |
| 1073752010 | Bradley George Gray | Family Medicine | 8726 Us Highway 42, Florence, KY 41042 | 2009-02-16 |
| 1124232020 | Bradley John Gray | Occupational Therapist | 325 9th Ave, Seattle, WA 98104-2420 | 2007-05-09 |
| Street Address |
2170 SOUTH AVE |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip Code | 96150-7026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881690485 | Marissa Rose Muscat | Family Medicine | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2005-06-28 |
| 1487201091 | Holly Anne Burnam | Registered Nurse | 2170 South Ave, South Lake Tahoe, CA 96150-7008 | 2019-08-20 |
| 1447725916 | Leeann Mills | Physical Therapy Assistant | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2018-10-10 |
| 1639653322 | Jessica Tina Cone | Occupational Therapist | 2170 South Ave, South Lake Tahoe, CA 96150-7008 | 2018-09-19 |
| 1972093391 | Jordan Corinne Myers | Technician | 2170 South Ave, South Lake Tahoe, CA 96150-7008 | 2018-05-10 |
| 1780185892 | Harrison Thomas Calhoun Brown | Physical Therapist | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2018-02-23 |
| 1578064788 | Morgan Humble | Physical Therapist | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2018-02-22 |
| 1326576893 | Heather Applegate | Physical Therapy Assistant | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2017-05-30 |
| 1306372214 | Julie Fernandez | Physical Therapist | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2017-05-11 |
| 1316480981 | Jordan Lewis Bugarske | Physical Therapy Assistant | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2016-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750818969 | Terri Wong | Behavior Technician | 908 Alameda Ave, #b, South Lake Tahoe, CA 96150 | 2017-05-18 |
| 1154735157 | Catherine Anne Jones | Dental Hygienist | 1088 4th St # 6, South Lake Tahoe, CA 96150 | 2014-06-17 |
| 1245663194 | Sheila Marie Gwin | Behavioral Analyst | 2111south Ave, South Lake Tahoe, CA 96150 | 2013-08-14 |
| 1164785598 | Launa Jean Martin | Doula | 1399 Bozeman Dr, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1881957355 | Elizabeth Marilyn Mcnamara | Emergency Medicine | Barton Memorial Hospital, 2107 South Ave, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1295034627 | Dana Elizabeth Cox | Chiropractor | 3097 Harrison Ave., # 202, S. Lake Tahoe, CA 96150 | 2011-03-24 |
| 1639485162 | April Lyn Westfall | Dentist | 3358 Sandy Way, # B, S Lake Tahoe, CA 96150 | 2010-08-21 |
| 1700199270 | Rollie E Rohnow | Pharmacist | 1020 Al Tahoe Blvd, Rite Aid Pharmacy, South Lake Tahoe, CA 96150 | 2010-07-26 |
| 1699000455 | Ellen Newell Mccullough | Physical Therapist | 1900 High Meadow Trail, South Lake Tahoe, CA 96150 | 2009-10-13 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| Find all providers in zip 96150 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013140177 | Abby Cohen Md A Medical Corporation | Family Medicine | 2209 South Ave, Suite B, South Lake Tahoe, CA 96150-7037 | 2009-08-24 |
| 1992765242 | Jenifer Elyce Norris | Family Medicine | 1108 4th St, South Lake Tahoe, CA 96150-3476 | 2006-03-23 |
| 1598740318 | Sierra Family Care Inc | Family Medicine | 2175 South Avenue, South Lake Tahoe, CA 96150 | 2005-12-14 |
| 1780679779 | Donald Patrick Martin | Family Medicine | 1108 4th Street, South Lake Tahoe, CA 96150 | 2005-09-15 |
| 1821098518 | Allison Leach Monroe | Family Medicine | 2155 South Ave, Ste 30, South Lake Tahoe, CA 96150-7038 | 2005-07-26 |
| 1205834306 | Brooks Martin | Family Medicine | 1090 3rd St, South Lake Tahoe, CA 96150-3485 | 2005-07-12 |
| 1851398671 | Gregory Walter Bergner | Family Medicine | 1067 4th St, South Lake Tahoe, CA 96150-3459 | 2005-07-07 |
| 1881690485 | Marissa Rose Muscat | Family Medicine | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2005-06-28 |
| 1629075205 | Richard Nils Peterson | Family Medicine | 2130 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6405 | 2005-06-28 |
| 1730518382 | Tamara Mcbride | Family Medicine | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2013-11-04 |
| Find all providers in SOUTH LAKE TAHOE | ||||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
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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.