Active NPI
Shae Ray
- Ambulatory Care Registered Nurse
- Rio Rancho, NM
National Provider Identifier
1003275959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- R67104
- Practice address
- 4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906 - Phone
- (505) 462-6000
- NPI assigned
- Feb 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | R67104 | NM | Primary |
Addresses
Primary practice location
4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906
Mailing address
4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R67104 | NM | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456012800000",
"number": "1003275959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4005 HIGH RESORT BLVD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871245906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4005 HIGH RESORT BLVD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871245906",
"telephone_number": "505-462-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "SHAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-21",
"last_updated": "2016-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "NM",
"license": "R67104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.