JACKSON GRAY PHD
NPI 1497371652
Clinical Neuropsychologist in Baltimore, MD

Active since June 23, 2020PECOS EnrolledAccepts Medicare Assignment
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231(920) 621-7263 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 11, 2022, Jun 23, 2020 (2 updates tracked since 2020).

About Jackson Gray Phd NPPES

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

JACKSON GRAY PHD (NPI 1497371652) is an individual clinical neuropsychologist in Baltimore, Maryland, licensed in Maryland (06711) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Columbus, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1497371652
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameJACKSON GRAYCredential: PHD
Location Address1750 E FAIRMOUNT AVEBaltimore, MD 21231-1534
Mailing Address2809 Boston St Apt 123Baltimore, MD 21224-4815 · (920) 621-7263
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 23, 2020
Last NPPES UpdateAugust 11, 20222 updates tracked since enumeration
NPPES CertifiedAugust 11, 2022
NPI 1497371652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License Licensed in MD · 06711
Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

1750 E FAIRMOUNT AVE, Baltimore, MD 21231

Secondary Practice Location 1

Location 1700 Childrens DrColumbus, OH 43205-2664 · Phone (614) 722-3713

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jackson Gray Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507234390
PECOS Enrollment IDI20221129001910
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.

Other Providers at the Same Location NPPES 20

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

Registered Nurse
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Student in an Organized Health Care Education/Training Program
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Speech-Language Pathologist
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Student in an Organized Health Care Education/Training Program
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Psychologist
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Clinical Neuropsychologist
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Speech-Language Pathologist
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231
Speech-Language Pathologist
1750 E FAIRMOUNT AVE
BALTIMORE, MD 21231

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 Jackson Gray's NPI number?

The NPI number for Jackson Gray is 1497371652. It was assigned to this individual provider in the NPPES registry on June 23, 2020.

Where is Jackson Gray located?

Jackson Gray practices at 1750 E Fairmount Ave, Baltimore, MD 21231. The listed phone number is (920) 621-7263.

What is Jackson Gray's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Jackson Gray enrolled in Medicare?

Yes. Jackson Gray is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jackson Gray accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Jackson Gray as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jackson Gray was last updated on August 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.