Lauren Bray

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

63263 Issued in MN

Practice address

3955 Parklawn Ave
Edina, MN 55435-5655

Phone

(952) 831-4454

NPI assigned

Apr 24, 2015

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southdale Pediatric Associates, LTD

  • Multi-Specialty Clinic/Center
  • Edina, MN
  • NPI 1245305895
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1033506357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PARKLAWN AVE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355655",
            "telephone_number": "952-831-4454",
            "fax_number": "952-278-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 PARKLAWN AVE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355655",
            "telephone_number": "952-831-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "63263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Wiger Branham, D.D.S.
• Constance Branson, OTR/L
• Charlotte Hopkins Branton, OTR/L
• Kathryn Bratko
• Bethany Brausen, PT, DPT, OCS
• Matthew Braza, MD
• Brittney T Bredemus, LP, PSYD, LADC, MA
• Nicky Diane Bredeson, LICSW LMFT
• Joshua Erin Breeding
• John David Breen, M.D.

• Pediatrics Physician in Edina, MN
• Providers in Edina, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.