COURTNEY ROSE GRAY (AGPCNP-BC) – Adult Health Nurse Practitioner, NPI 1215445622
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,023 NURSE PRACTITIONER in MO
Provider Addresses for COURTNEY ROSE GRAY (AGPCNP-BC)
620 Maple Valley Dr
Farmington, MO 636401976
Phone: (636) 933-5055
Type: Location
1400 US Highway 61 Ste 240B
Festus, MO 630284141
Phone: (636) 933-2344
Fax: (636) 937-9031
Type: Location
1625 SHADOW OAK DR
FESTUS, MO 630283376
Phone: (314) 401-0111
Type: Mailing
1390 US HIGHWAY 61 STE N1500
FESTUS, MO 63028
Phone: (636) 933-5055
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 61 Open Payments records for all available years, with a total value of $1,231.
Total Amount is formed as General ($1,231) + Research ($0) + Ownership ($0) = $1,231.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($242).
Total Amount
$1,231
General + Research + Ownership
Payments
61
Total payment records
General Amount
$1,231
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-03-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180326000659 | I | Nurse Practitioner | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 243 | 162 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 31 | 29 | $0 |
| 93005 | Routine electrocardiogram (ecg) using at least 12 leads with tracing | 18 | 18 | $0 |
Insurance plans in this area (ZIP 63640)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | MO | |
| Cardiovascular Disease (Cardiology), Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Internal Medicine, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology), Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| - | MO |
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