1. Home
  2. Directory
  3. Oklahoma
  4. Norman
  5. Psychiatry Neurology
  6. NPI Profile
  7. NPI Record 1295708519

DR. JACK KENNETH GRAY JR. MD
Complete NPI Record 1295708519
Psychiatry & Neurology - Psychiatry in Norman, OK

NPI Status: Active since February 08, 2006

Contact Information

909 ALAMEDA ST
NORMAN, OK
ZIP 73071
Phone: (405) 573-3934
Fax: (405) 573-3962

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Name Suffix Text
  8. Provider Credential Text
  9. Provider First Line Business Mailing Address
  10. Provider Second Line Business Mailing Address
  11. Provider Business Mailing Address City Name
  12. Provider Business Mailing Address State Name
  13. Provider Business Mailing Address Postal Code
  14. Provider Business Mailing Address Country Code If outside U S
  15. Provider Business Mailing Address Telephone Number
  16. Provider Business Mailing Address Fax Number
  17. Provider First Line Business Practice Location Address
  18. Provider Business Practice Location Address City Name
  19. Provider Business Practice Location Address State Name
  20. Provider Business Practice Location Address Postal Code
  21. Provider Business Practice Location Address Country Code If outside U S
  22. Provider Business Practice Location Address Telephone Number
  23. Provider Business Practice Location Address Fax Number
  24. Provider Enumeration Date
  25. Last Update Date
  26. Provider Gender Code
  27. Healthcare Provider Taxonomy Code 1
  28. Provider License Number 1
  29. Provider License Number State Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Healthcare Provider Taxonomy Code 2
  32. Provider License Number 2
  33. Provider License Number State Code 2
  34. Healthcare Provider Primary Taxonomy Switch 2
  35. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1295708519. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1295708519
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The date that a record was last updated or changed.
The code designating the provider’s gender if the provider is a person.
Provider First Name: JACK
The first name of the provider, if the provider is an individual.
Provider Middle Name: KENNETH
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Name Suffix Text: JR.
The name suffix of the provider if the provider is an individual. The name suffix is a ‘‘generation-related’’ suffix, such as Jr., Sr., II, III, IV, or V.
Provider Credential Text: MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 909 ALAMEDA ST
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: PO BOX 400
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: NORMAN
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: OK
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 730715229
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 4055733934
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 4055733962
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 909 ALAMEDA ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: NORMAN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: OK
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 730715229
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 4055733934
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 4055733962
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/8/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 3/24/2008
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 2084P0800X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 15966
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: OK
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Healthcare Provider Taxonomy Code 2: 2084P0800X
Provider License Number 2: 19414
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: TN
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No