NICOLE K GRAY (PA) – Physician Assistant, NPI 1124385752
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,118 PHYSICIAN ASSISTANT in TN
Provider Addresses for NICOLE K GRAY (PA)
2333 MCCALLIE AVE
CHATTANOOGA, TN 374043258
Phone: (423) 698-6061
Type: Location
601 DODDS AVE
CHATTANOOGA, TN 374043911
Phone: (423) 453-8999
Fax: (866) 401-5838
Type: Location
2333 McCallie Ave
Chattanooga, TN 374043258
Phone: (423) 698-6061
Type: Location
1431 CENTERPOINT BLVD
SUITE 100
KNOXVILLE, TN 379321984
Phone: (865) 539-8000
Fax: (865) 985-7077
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-12-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20120918000576 | I | Physician Assistant | TN | TBD |
| I20251231004362 | I | Physician Assistant | WV | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37404)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | HI | |
| Nurse Practitioner | AZ | |
| Internal Medicine, Nephrology | LA | |
| Nurse Practitioner | MA | |
| Internal Medicine, Nephrology | UT | |
| Nurse Practitioner | OH | |
| Physician Assistant | OH | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ |
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