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Deactivated NPI 1659480754 Deactivated / Inactive NPI Female Practitioner

Phoebe Sue Gray , RN, PNP

Nurse Practitioner - Pediatrics • Boise, ID

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Phoebe Gray has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 30, 2006
NPI Deactivation Date February 13, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Phoebe Gray, RN, PNP was a registered Nurse Practitioner - Pediatrics practicing in Boise, ID. Throughout an active medical career spanning 14 years, Phoebe Gray provided care at the practice location at 777 N RAYMOND ST until profile deactivation on 2020-02-13.

Practice Location & Contact Primary Location

Practice Address

777 N Raymond St

Boise, ID 837049251

Telephone 2083676030
Fax 2083676123
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Boise, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.7 Yrs
State Avg: 7.7 Yrs
Regional Practice Density
25 Specialists

Practicing in Boise, ID (60 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License ID NP256A

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Steve Kerr , MSW, LCSW

Counselor - Professional

NPI 1083641625

Master of Social Work, Licensed Clinical Social Worker

Dr. Justin Glass , MD

Family Medicine

NPI 1194820852

Doctor of Medicine (M.D.)

Dr. Olivia Galvez , MD

Family Medicine

NPI 1215975677

Doctor of Medicine (M.D.)

Charles Sherwood , PA-C

Physician Assistant

NPI 1215979000

Physician Assistant (Certified)

Dr. Derek Jackson , MD

Family Medicine

NPI 1225299357

Doctor of Medicine (M.D.)

NPI 1275577207

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 13, 2020

Record deactivated on February 13, 2020

NPI Profile Active May 13, 2008

NPI status registered as active in NPPES database

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Updated Practice Location May 13, 2008

Registered at 777 N RAYMOND ST, BOISE, ID 837049251 (Tel: 2083676030)

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Updated Business Mailing Address May 13, 2008

Registered at 6208 S MOON PL, BOISE, ID 837097893 (Tel: 2083626291)

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Provider Name / Credentials Updated May 13, 2008

Recorded as PHOEBE GRAY, R.N., P.N.P.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 13, 2008

Nurse Practitioner (License #NP256A in ID)

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Initial NPI Registration & Enumeration August 30, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659480754
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 30, 2006
Last Update: May 13, 2008
Deactivation Date: February 13, 2020

Mailing Address

6208 S Moon Pl

Boise, ID 837097893

Phone: 2083626291

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.