Provider Demographics
NPI:1407902026
Name:GRAY, RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5600 S QUEBEC STREET
Mailing Address - Street 2:SUITE 312A
Mailing Address - City:GREENWOOD VILLIAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2208
Mailing Address - Country:US
Mailing Address - Phone:720-754-2296
Mailing Address - Fax:844-669-1725
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:IM HOSPITALIST
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1235
Practice Address - Country:US
Practice Address - Phone:720-754-2296
Practice Address - Fax:844-669-1725
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45603207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03318114Medicaid
KS200716410AMedicaid
NM63954044Medicaid
SD7725870Medicaid
CO23137355Medicaid
NE10025742100Medicaid
WY1407902026Medicaid
COP00768708Medicare PIN
COCO301141Medicare PIN
NY03318114Medicaid
COP01129453Medicare PIN