Active NPI
Everett B Wray III, M.D.
- Cardiovascular Disease Physician
- Huntington, WV
National Provider Identifier
1013940436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 10053
- Practice address
- 1249 15TH Street
Suite 4000
Huntington, WV 25701 - Phone
- (304) 691-8500
- Fax
- (304) 691-8510
- NPI assigned
- Jul 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 34094 | TN | |
| Cardiovascular Disease Physician | 207RC0000X | 10053 | WV | Primary |
Addresses
Primary practice location
1249 15TH Street
Suite 4000
Huntington, WV 25701
Mailing address
1249 15TH Street
Suite 4000
Huntington, WV 25701
Phone (304) 691-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0087197000 | Medicaid | WV |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34094 | TN | MD | Cardiovascular Disease Physician |
| 10053 | WV | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freeman-Oak Hill Health System | Past | Accepting new patients | |
| Heart Group PLLC | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Joplin, MO
- NPI 1679517023
-
- Cardiovascular Disease Physician
- Nashville, TN
- NPI 1861442592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1013940436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1249 15TH STREET",
"address_2": "SUITE 4000",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25701",
"telephone_number": "304-691-8500",
"fax_number": "304-691-8510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1249 15TH STREET",
"address_2": "SUITE 4000",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25701",
"telephone_number": "304-691-8500",
"fax_number": "304-691-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRAY",
"first_name": "EVERETT",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-09",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "34094",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WV",
"license": "10053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0087197000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.