Individual provider Active NPI

Michelle Marie Bray, DO

  • Family Medicine Physician
  • Offutt AFB, NE
National Provider Identifier
1043473325
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02003693A Issued in IN
Practice address
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Phone
(402) 294-9459
NPI assigned
Jul 7, 2008
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 02003693A IN Primary

Addresses

Primary practice location

2501 Capehart Rd
Offutt AFB, NE 68113-1043

Mailing address

2501 Capehart Rd
Offutt AFB, NE 68113-1043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20161209001782 WY Order and Referring Only - Family PracticePractitioner - Family Practice 9739469677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1043473325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-294-9459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003693A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Offutt AFB, NE

Sources for this page

Verify at the official NPI Registry.