DR. SUSAN MARIE GRAY (NPI# 1558347252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558347252 |
| Entity Type | Individual |
| Full Name | DR. SUSAN MARIE GRAY |
| Other Name | SUSAN GRAY KASELONIS |
| Credential | MD |
| Practice Address |
4701 Montgomery Blvd Ne Albuquerque NM 87109-1219 |
| Mailing Address |
Po Box 452036 Sunrise FL 33345-2036 |
| Practice Telephone | 5057278104 |
| Mailing Telephone | 9548382371 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
81-210 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 00005223 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835964 | Susan Ann Gray | Physical Therapist | 12435 Jewel Stone Ln, Fort Myers, FL 33913-6752 | 2019-11-13 |
| 1538402193 | Susan Gray | Speech-Language Pathologist | 69 Lincoln Ave, Hastings On Hudson, NY 10706-2505 | 2013-04-02 |
| 1023387511 | Susan Mary Gray | Pharmacist | 1407 Ridgefield Dr, Des Peres, MO 63131-3636 | 2011-12-29 |
| 1053558577 | Susan Jane Gray | Nurse Practitioner | 915 Fern Hill Rd, Building A Suite 3, West Chester, PA 19380-4269 | 2009-01-21 |
| 1558483974 | Susan D. Gray | Chiropractor | 5416 N Maryland Ave, Portland, OR 97217-4548 | 2007-04-05 |
| 1770616559 | Susan Kay Gray | Nurse Practitioner | 109 N Chestnut, Onarga, IL 60955 | 2007-03-13 |
| 1649340225 | Susan Thomas Gray | Obstetrics & Gynecology | 1394 Hatcher Ln, Columbia, TN 38401-3568 | 2006-11-09 |
| 1083707400 | Susan Louise Gray | Speech-Language Pathologist | 12109 Sw 56th St, Mustang, OK 73064-7264 | 2006-09-30 |
| 1043251382 | Susan K. Gray | Nurse Practitioner | 22 Beverly Court, Metuchen, NJ 08840-3266 | 2006-06-09 |
| 1831723378 | Susan L Gray | Case Manager/Care Coordinator | 4761 State Route 29, Celina, OH 45822-8216 | 2020-02-24 |
| Street Address |
4701 MONTGOMERY BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-1219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245213750 | Sheridan Children Healthcare Services of New Mexico Inc | Pediatrics | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2005-11-29 |
| 1831705094 | Rachel Leanne Garcia | Midwife | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2020-09-22 |
| 1184236523 | Chanae D Esquibel | Physical Therapist | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2020-08-18 |
| 1841816170 | Chitose Hanert | Occupational Therapist | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2020-06-23 |
| 1295350098 | Kerry Elizabeth Trautwein | Occupational Therapist | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2020-06-08 |
| 1669007332 | Rachel Henderson | Registered Nurse | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2020-03-03 |
| 1578106829 | Nicole Lerma Hadley | Physical Therapy Assistant | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2019-10-18 |
| 1902463524 | David Bowers | Physical Therapy Assistant | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2019-05-20 |
| 1376109181 | Kanna Shepherd | Occupational Therapist | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2019-05-16 |
| 1295220457 | Rebecca Echols | Nurse Practitioner | 4701 Montgomery Blvd Ne, Albuquerque, NM 87109-1219 | 2018-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235468331 | Jessie Ruth Maxwell | Pediatrics | Pediatrics Neonatology Msc10 5590, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2009-12-18 |
| 1730352154 | Dawn L Novak | Pediatrics | 3601 Yipee Calle Ct Nw, Albuquerque, NM 87120-2381 | 2008-04-07 |
| 1457534562 | Agatha R Norwood | Pediatrics | 201 Cedar Se, Ste 508, Albuquerque, NM 87106 | 2007-12-12 |
| 1235144783 | Dale C Alverson | Pediatrics | 1005 Columbia Dr Ne, Albuquerque, NM 87106-2626 | 2006-07-30 |
| 1497760961 | Kristi Watterberg | Pediatrics | 3 Rd Floor Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-07-30 |
| 1578578035 | Curtis Daniel Caldwell | Pediatrics | Department of Pediatrics Neonatology Msc10, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-07-30 |
| 1104047265 | Tara Lynn Dupont | Pediatrics | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2745 | 2007-05-02 |
| 1225122286 | Ronald L. Poland | Pediatrics | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2745 | 2006-10-03 |
| 1396752358 | Teal Peck | Pediatrics | 3rd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-02 |
| 1548276116 | Keith Holtzclaw | Pediatrics | 3rd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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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.