Kelly Bray

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.127747 Issued in IL

Practice address

2035 S Indiana Ave
312
Chicago, IL 60616-4925

Phone

(773) 209-9925

NPI assigned

Aug 18, 2010

Last updated

Dec 9, 2011By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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 Osteopathy

State licenses

Practice roles

Locations

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.

• Monticello Emergency Care, LLC

  • Emergency Medicine Physician
  • Bloomington, IN
  • NPI 1003849399
  Medicare reassignment NPD

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1043525785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 S INDIANA AVE",
            "address_2": "312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164925",
            "telephone_number": "773-209-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 S INDIANA AVE",
            "address_2": "312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164925",
            "telephone_number": "773-209-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.127747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Julius Brawka, M.D.
• Caitlyn Bray
• Clark A Bray
• Colleen M Bray, OTR/L
• Fraces Bray
• Molly A Bray, RD,LD
• Dana Brazdziunas, MD
• Adam James Braze, D.O.
• Pamela Ann Brazelton-Sykes, MA, MS
• Gabrielle Brazg, PT, DPT

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.