DR. THERESA GRAY DPM NPI 1386025377

NPI Information

NPI: 1386025377
Provider Name: DR. THERESA GRAY, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

Organization: PROGRESSIVE COMMUNITY HEALTH CENTERS INC

PECOS Registration: Yes

Address:
3522 W LISBON AVE
MILWAUKEE, WI
ZIP 53208
Phone: (414) 935-8000
Get Directions

DR. Theresa Gray, DPM is a foot and ankle surgery podiatrist in Milwaukee, WI with 9 years of experience. DR. Theresa Gray, DPM NPI is 1386025377. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year:2015

The provider's business location address is:

3522 W LISBON AVE
MILWAUKEE, WI
ZIP 53208-953
Phone: (414) 935-8000
Fax: (414) 344-3350

The NPI 1386025377 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/15/2015 and was last updated on 6/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	1111-25	WISCONSIN	Yes
2	213E00000X	Podiatrist		1111-25	WISCONSIN	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100076793	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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