NPIMap

Individual provider Active NPI

Kelli M Ray, PA-C

  • Physician Assistant
  • Albion, NE
National Provider Identifier
1043541808
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1480 Issued in NE
Practice address
1019 S 8TH St
Albion, NE 68620-1760
Phone
(402) 395-5013
Fax
(402) 395-2327
NPI assigned
Jan 19, 2010
Last updated
Jul 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1480 NE Primary

Addresses

Primary practice location

1019 S 8TH St
Albion, NE 68620-1760

Mailing address

PO Box 151
Albion, NE 68620-0151
Phone (402) 395-5013

Other names 1

  • Ms. Kelli M. Frey Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelliray@boonecohealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317001098 NE Practitioner - Physician Assistant 2961537709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone County Health CenterGroup PAC ID 1254306178, shared by 9 NPIs, 19 clinicians

Practice addresses (Care Compare)

723 W Fairview St
Albion, NE 68620-1767
Phone (402) 395-2191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1480NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Health Center Physician Assistant CurrentSince Jan 11, 2010 Accepting new patients
Boone County Health Center CurrentSince Jan 11, 2010 Accepting new patients
Boone County Health Center Current Accepting new patients
Boone County Health Center Past Accepting new patients
Boone County Health Center Past Accepting new patients

Locations

1019 S 8th St
Albion, NE 68620
Phone (402) 395-5013

1173 S 8th St
Albion, NE 68620
Phone (402) 395-5013

723 W Fairview St
Albion, NE 68620
Phone (402) 385-3149

Interoperability endpoints

  • Direct secure messaging: kelliray@boonecohealth.cernerdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1043541808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "ALBION",
            "state": "NE",
            "postal_code": "686200151",
            "telephone_number": "402-395-5013",
            "fax_number": "402-395-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 S 8TH ST",
            "city": "ALBION",
            "state": "NE",
            "postal_code": "686201760",
            "telephone_number": "402-395-5013",
            "fax_number": "402-395-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "KELLI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelliray@boonecohealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1019 S 8th St",
            "city": "Albion",
            "state": "NE",
            "country_code": "US",
            "postal_code": "686201760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "FREY",
            "middle_name": "M.",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albion, NE

Sources for this page

Verify at the official NPI Registry.