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Deactivated NPI 1306081914 Deactivated / Inactive NPI Female Practitioner

Keshell Antron Gray , MS, CCC-SLP

Speech-Language Pathologist • Southaven, MS

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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, Keshell Gray has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 10, 2008
NPI Deactivation Date August 24, 2018
Total Practice Duration ~10 Years of Practice (2008 – 2018)

Professional Overview & Biography Verified Profile Summary

Keshell Gray, MS, CCC-SLP was a registered Speech-Language Pathologist practicing in Southaven, MS. Throughout an active medical career spanning 10 years, Keshell Gray provided care at the practice location at 7160 TCHULAHOMA RD until profile deactivation on 2018-08-24.

Practice Location & Contact Primary Location

Practice Address

7160 Tchulahoma Rd
Bldg. B Suite 4

Southaven, MS 386719266

Telephone 6623492733
Associated Practice Facility / Clinic
🏢 Therapy Zone, Llc Facility NPI 1194836056

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Southaven, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.7 Yrs
Regional Practice Density
60 Specialists

Practicing in Southaven, MS (1519 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

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License MS S3231

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
09015269 (MS)

Practice Associates & Co-Workers

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

18 Associated Practitioners
Cheryl Jordan , MS CCC-SLP

Speech-Language Pathologist

NPI 1245361690

MSCCCSLP

Kayla Desutter , SLP

Speech-Language Pathologist

NPI 1255769337

Speech-Language Pathologist

Kaby Plitt , MS CCC SLP

Speech-Language Pathologist

NPI 1336270602

MSCCCSLP

Stephanie Ledbetter , OTR, L, MOT

Occupational Therapist - Pediatrics

NPI 1346557766

Occupational Therapist Registered, L, Master of Occupational Therapy

Taylor Jones

Occupational Therapist

NPI 1437552932
Chelcey Wells

Speech-Language Pathologist

NPI 1508168113

Career & Practice History Timeline

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

8 Historical Events
🔄
NPI Profile Reactivated September 08, 2018

Record officially reactivated for active practice on September 08, 2018

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NPI Profile Deactivated August 24, 2018

Record deactivated on August 24, 2018

NPI Profile Active December 10, 2008

NPI status registered as active in NPPES database

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Updated Practice Location December 10, 2008

Registered at 7160 TCHULAHOMA RD, BLDG. B SUITE 4, SOUTHAVEN, MS 386719266 (Tel: 6623492733)

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Updated Business Mailing Address December 10, 2008

Registered at 197 IRA RD, MOUND BAYOU, MS 387629708 (Tel: 6627412185)

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Provider Name / Credentials Updated December 10, 2008

Recorded as KESHELL GRAY, M.S., CCC-SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2008

Speech-Language Pathologist (License #S3231 in MS)

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Initial NPI Registration & Enumeration December 10, 2008

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: 1306081914
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 10, 2008
Last Update: September 08, 2018
Deactivation Date: August 24, 2018
Sole Proprietor: No

Mailing Address

197 Ira Rd

Mound Bayou, MS 387629708

Phone: 6627412185

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.