GRAY DERM PLLC
NPI 1104392679
Dermatology in Lima, OH

Q: What is Gray Derm PLLC's NPI number?

The NPI number for Gray Derm PLLC is 1104392679. It was assigned to this organization in the NPPES registry on October 22, 2018. The provider is doing business as Gray Derm LLC and Gray Dermatology & Cosmetic Surgery.

Q: What is Gray Derm PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Gray Derm PLLC was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 22, 2018CLIA Certified · 3 labs

750 W HIGH ST STE 300, LIMA, OH 45801(419) 229-6781(614) 386-9506 Get Directions Write a Review

NPPES record last updated: February 4, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Feb 4, 2026, Jan 12, 2023, Nov 13, 2019 and 2 more (5 updates tracked since 2018).

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About Gray Derm Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAY DERM PLLC (NPI 1104392679), doing business as Gray Derm Llc, is a healthcare organization registered as a dermatology in Lima, Ohio and active in the NPI registry since October 2018. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Bryan Gray, Do/practice Owner, as its authorized official.

NPPES Registry Identity

NPI1104392679

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameGRAY DERM PLLC

Location Address750 W HIGH ST STE 300Lima, OH 45801-2967

Mailing Address750 W High St Ste 300Lima, OH 45801-2967 · (419) 229-6781 · Fax (614) 386-9506

Phone(419) 229-6781

Fax(614) 386-9506

Organization SubpartNo

Authorized OfficialBryan GrayDo/practice Owner · (614) 596-6789

Enumeration DateOctober 22, 2018

Last NPPES UpdateFebruary 4, 20265 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2026

✔ NPI 1104392679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X

750 W HIGH ST STE 300, Lima, OH 45801

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Other Names 2

Doing Business AsGray Derm Llc

Doing Business AsGray Dermatology & Cosmetic Surgery

Secondary Practice Locations 2

Location 1609 E Chestnut StLancaster, OH 43130-3900 · Phone (740) 206-7131

Location 21005 Bellefontaine Ave Ste 300Lima, OH 45804-2881 · Phone (419) 998-8297 · Fax (419) 226-8309

Other Identifiers 2

Other34.013501OH · Oh License

Other5101021720MI · Mi License

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 36D2237051

Gray Dermatology & Cosmetic Surgery · Lancaster, OH

Active · expires Feb 9, 2028

CLIA Number36D2237051

Laboratory TypePhysician Office

Certificate Effective DateFebruary 10, 2026

Certificate Expiration DateFebruary 9, 2028

Laboratory DirectorDr. Bryan D. Gray

Laboratory Phone(740) 206-7131

Laboratory LocationGray Dermatology & Cosmetic Surgery609 E Chestnut St, Lancaster, OH 43130

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 36D2174852

Gray Dermatology & Cosmetic Surgery Of Lima · Lima, OH

Active · expires Jan 26, 2028

CLIA Number36D2174852

Laboratory TypePhysician Office

Certificate Effective DateJanuary 27, 2026

Certificate Expiration DateJanuary 26, 2028

Laboratory DirectorDr. Bryan D. Gray

Laboratory Phone(419) 998-8297

Laboratory LocationGray Dermatology & Cosmetic Surgery Of Lima1005 Bellefontaine Ave, Suite 300, Lima, OH 45804

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 36D0994541

Gray Dermatology & Cosmetic Surgery · Lima, OH

Active · expires Nov 10, 2026

CLIA Number36D0994541

Laboratory TypePhysician Office

Certificate Effective DateNovember 11, 2024

Certificate Expiration DateNovember 10, 2026

Laboratory DirectorDr. Bryan D. Gray

Laboratory Phone(419) 229-6781

Laboratory LocationGray Dermatology & Cosmetic Surgery750 W High St Suite 300, Lima, OH 45801

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY JO CLEEMPUT CNS

Nurse Practitioner (Family)