Jerrold Gray (NPI# 1962583120, PAC ID# 4082888706) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1962583120 |
| PAC ID by PECOS | 4082888706 |
| Professional Enrollment ID | I20111115000548 |
| Full Name | Jerrold Gray |
| Organization Legal Name | MAUMEE VALLEY GUIDANCE CENTER INC |
| Address |
211 Biede Ave Defiance OH 43512-2408 |
| Phone Number | 4197828856 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF OHIO |
| Graduation Year | 1995 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 0547293003 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 361333 | FULTON COUNTY HEALTH CENTER |
| 361309 | HENRY COUNTY HOSPITAL, INC |
| 360270 | MERCY HOSPITAL OF DEFIANCE |
| 360121 | COMMUNITY HOSPITALS AND WELLNESS CENTERS |
| 361328 | PROMEDICA DEFIANCE REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 211 Biede Ave, Defiance, OH 43512-2408 | 4197828856 | MAUMEE VALLEY GUIDANCE CENTER INC |
| Organization Legal Name | MAUMEE VALLEY GUIDANCE CENTER INC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicole R Jackson | Nurse Practitioner | Maumee Valley Guidance Center Inc | 222 Depot St, Wauseon, OH 43567-1381 |
| Jennifer D Wang | Nurse Practitioner | Maumee Valley Guidance Center Inc | 910 E Maple St, Bryan, OH 43506-1841 |
| Anne M Mallett | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Craig W Parliment | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Tonya Edmondson | Nurse Practitioner | Maumee Valley Guidance Center Inc | 910 E Maple St, Bryan, OH 43506-1841 |
| Katherine Shaffer | Clinical Social Worker | Maumee Valley Guidance Center Inc | 910 E Maple St, Bryan, OH 43506-1841 |
| Cassandra Mcconn | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Tess Homier | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Street Address |
211 BIEDE AVE |
| City | DEFIANCE |
| State | OH |
| Zip | 43512-2408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anne M Mallett | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Craig W Parliment | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Cassandra Mcconn | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Tess Homier | Clinical Social Worker | Maumee Valley Guidance Center Inc | 211 Biede Ave, Defiance, OH 43512-2408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David C Deal | Psychologist, Clinical | 1450 S Clinton, Defiance, OH 43512 | |
| Melissa R Davies | Psychologist, Clinical | 1125 Ralston Ave, Defiance, OH 43512-1336 | |
| Thomas L Flanigan | Plastic and Reconstructive Surgery | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Brenda M Brady | Psychiatry | Defiance Hospital Inc. | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Randal D Martin | Certified Registered Nurse Anesthetist (crna) | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Matthew M Reiner | Podiatry | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Jessica Lynn Saunders | Nurse Practitioner | Omni Health Services, Ltd | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Trisha K Davis | Nurse Practitioner | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Truman F Weigand Jr. | General Surgery | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Aban A Affan | Anesthesiology | Promedica Central Physicians LLC | 1200 Ralston Ave, Defiance, OH 43512-1396 |
| Find all physicians in zip 43512 | |||
| City | DEFIANCE |
| Zip Code | 43512 |
| Specialty | PSYCHIATRY |
| City + Specialty | DEFIANCE + PSYCHIATRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.