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KATHLEEN E GRAY ARNP
NPI 1124393418
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, FL

Active since March 20, 2012PECOS Enrolled
1636 SHADOWOOD LN STE 120, JACKSONVILLE, FL 32207(904) 725-9701(904) 725-9694 Get Directions Write a Review

NPPES record last updated: February 16, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kathleen E Gray Arnp NPPES

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

KATHLEEN E GRAY ARNP (NPI 1124393418) is an individual psychiatric/mental health provider in Jacksonville, Florida, licensed in Florida (ARNP2844802) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124393418
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKATHLEEN E GRAYCredential: ARNP
Location Address1636 SHADOWOOD LN STE 120Jacksonville, FL 32207-2187
Mailing AddressPo Box 19249Jacksonville, FL 32245-9249 · (904) 743-1883 · Fax (904) 743-5109
Phone(904) 725-9701
Fax(904) 725-9694
Sole ProprietorNo
Enumeration DateMarch 20, 2012
Last NPPES UpdateFebruary 16, 2022
NPPES CertifiedFebruary 16, 2022
✔ NPI 1124393418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in FL · ARNP2844802
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License ARNP2844802 (FL)
1636 SHADOWOOD LN STE 120, Jacksonville, FL 32207
Open in Google Maps ↗

Other Identifiers 1

Medicaid7663463FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen E Gray Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kathleen Gray reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health Resource Center Inc
6.7 mi
Community Health
11820 BEACH BLVD
Jacksonville, FL 32246
  • Reassigned Medicare billing, Florida enrollment
  • 30 clinicians in this Medicare group
NPI 1851407365 (904) 642-9100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32207 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

MENTAL HEALTH RESOURCE CENTER INC
Clinic/Center (Community Health)
1636 SHADOWOOD LN STE 120
JACKSONVILLE, FL 32207
Duval County (904) 725-9701
REBECCA HEATHER POPE LMHC
Counselor (Mental Health)
1636 SHADOWOOD LN STE 120
JACKSONVILLE, FL 32207
Duval County (904) 725-9701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Gray's NPI number?

The NPI number for Kathleen Gray is 1124393418. It was assigned to this individual provider in the NPPES registry on March 20, 2012.

Where is Kathleen Gray located?

Kathleen Gray practices at 1636 Shadowood Ln Ste 120, Jacksonville, FL 32207. The listed phone number is (904) 725-9701.

What is Kathleen Gray's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kathleen Gray enrolled in Medicare?

Yes. Kathleen Gray is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kathleen Gray's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Gray reassigns Medicare benefits to Mental Health Resource Center Inc (Jacksonville, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Gray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathleen Gray was last updated on February 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.