MR. CLARENCE EDWARD GRAY JR. (NPI# 1154580405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154580405 |
| Entity Type | Individual |
| Full Name | MR. CLARENCE EDWARD GRAY JR. |
| Practice Address |
275 Courtlyn Way Mcdonough GA 30252-6997 |
| Practice Telephone | 6782342082 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932653714 | Clarence Gray | Counselor | 134 W College Ave, San Angelo, TX 76903-5816 | 2016-08-09 |
| 1649362773 | Clarence Patrick Gray | Dentist | G3222 Beecher Rd, Flint, MI 48532 | 2006-09-28 |
| 1366505471 | Clarence Nicholas Gray | Chiropractor | 1405 East Main Street, Antlers, OK 74523 | 2006-12-19 |
| Street Address |
275 COURTLYN WAY |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30252-6997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114427 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 3479 Highway 81 East, Mcdonough, GA 30252 | 2020-11-03 |
| 1770143547 | Kevin Kirk Anderson | Physical Therapist | Dr. Kevin Anderson, 196 Lake Dow Rd, Mcdonough, GA 30252 | 2019-06-14 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1194271320 | Christine Williams Breeden | Registered Nurse | 189 Irwin Drive, Mcdonough, GA 30252 | 2016-08-28 |
| 1518322395 | Jaquita Shorts | Counselor | 1705 Pennslyvania Ave, Mcdonough, GA 30252 | 2015-12-22 |
| 1356758973 | Keisha Candies | Counselor | 125 Zack Hinton Pkwy, Mcdonough, GA 30252 | 2014-07-15 |
| 1093145666 | Ceisha Shador Parks | Counselor | 6040 Winston Trace, Mcdonough, GA 30252 | 2013-11-19 |
| 1588939565 | Tasha E Jones | Counselor | 1509 Bent River Cir, Mcdonough, GA 30252 | 2012-03-09 |
| 1598049447 | Proactive Rehab, Inc | Physical Therapist | 50 Lawrenceville Street, Suite 100, Mcdonough, GA 30252 | 2011-10-10 |
| 1164706131 | Michelle Lee Cone | Pharmacist | 1210 Bent Creek Dr, Mcdonough, GA 30252 | 2011-10-07 |
| Find all providers in zip 30252 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| 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 |
|---|---|---|---|---|
| 1114535432 | Beauty Zone2 Medical Wigs | Prosthetic/Orthotic Supplier | 252 Keys Ferry St, Mcdonough, GA 30253-3342 | 2020-07-22 |
| 1770659385 | Cross Creek Enterprise, Inc. | Prosthetic/Orthotic Supplier | 1778 Jonesboro Rd, Mcdonough, GA 30253-5900 | 2006-11-27 |
| 1770081010 | Unique Creations Hair Studios II, LLC | Prosthetic/Orthotic Supplier | 303 Jonesboro Rd, Mcdonough, GA 30253-3725 | 2018-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860810 | Crowns of Love Inc | Prosthetic/Orthotic Supplier | 707 Park Ave Ne Apt 1382, Atlanta, GA 30326-3410 | 2020-10-27 |
| 1447860150 | Shadae Renee Medical Wigs | Prosthetic/Orthotic Supplier | 10719 Alpharetta Hwy # 1792, Roswell, GA 30076-2432 | 2020-08-06 |
| 1619594389 | Legally Laced | Prosthetic/Orthotic Supplier | 1000 Corporate Pointe Ste 214, Warner Robins, GA 31088-3440 | 2020-06-29 |
| 1093332009 | Jazzy Wigs, Rx | Prosthetic/Orthotic Supplier | 59 Urey Emerson Dr, Richland, GA 31825-6636 | 2020-06-25 |
| 1174147938 | Salon Asya Mignon LLC | Prosthetic/Orthotic Supplier | 4290 Memorial Dr Ste B1, Decatur, GA 30032-1225 | 2020-06-07 |
| 1023630928 | Michelles Beauty Bar | Prosthetic/Orthotic Supplier | 3662 Druid Oaks Dr, Valdosta, GA 31605-6542 | 2020-05-13 |
| 1366063596 | Stylish Styles By Tee | Prosthetic/Orthotic Supplier | 6595 Roswell Rd Ste G1169, Atlanta, GA 30328-3152 | 2020-04-28 |
| 1518503432 | Regina Murff-love | Prosthetic/Orthotic Supplier | 341 Indus Ln, Lawrenceville, GA 30044-3835 | 2019-11-26 |
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1811545650 | Salon Bar LLC | Prosthetic/Orthotic Supplier | 4705 Ashford Dunwoody Rd # 4, Dunwoody, GA 30338-5566 | 2019-08-26 |
| 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.