Healthcare Provider Details

I. General information

NPI: 1982317889
Provider Name (Legal Business Name): MEGAN GRAY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 PARK RD STE 105
CHARLOTTE NC
28209-3815
US

IV. Provider business mailing address

1429 BRYANT ST STE A
CHARLOTTE NC
28208-5201
US

V. Phone/Fax

Practice location:
  • Phone: 704-919-1491
  • Fax:
Mailing address:
  • Phone: 704-919-0867
  • Fax: 704-817-8579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberP21775
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: