Individual provider Active NPI

Wesley Clark Ray, M.D.

  • Internal Medicine Physician
  • Nashville, TN
National Provider Identifier
1063403434
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD019992 Issued in TN
Practice address
222 22ND Ave N
Nashville, TN 37203-1852
Phone
(629) 255-2153
Fax
(629) 255-4041
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD019992 TN Primary

Addresses

Primary practice location

222 22ND Ave N
Nashville, TN 37203-1852

Mailing address

222 22ND Ave N
Nashville, TN 37203-1852
Phone (629) 255-3486

Other practice location 1

222 22nd Ave N
Suite 100
Nashville, TN 37203-1852
Phone (615) 324-2149

Other identifiers 2

IdentifierTypeStateIssuer
Q018215MedicaidTN
3065839MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20091214000009 TN Practitioner - Internal Medicine 5597805143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Medical Associates PCGroup PAC ID 4688651037, 162 clinicians

Practice addresses (Care Compare)

222 22ND Ave N
Nashville, TN 37203-1852
Phone (629) 255-3486

Hospital & facility affiliations

  • Tristar Healthcare at Home Home health agency, Nashville, TN, CCN 447583
  • Highpoint Hospice Hospice, Gallatin, TN, CCN 441513
  • Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD019992TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Medical Associates PC Internal Medicine CurrentSince Mar 26, 1993 Accepting new patients
Heritage Medical Associates PC CurrentSince Mar 26, 1993 Accepting new patients

Locations

222 22nd Ave N
Nashville, TN 37203
Phone (629) 255-2620

222 22nd Ave N
Ste 100
Nashville, TN 37203
Phone (615) 284-2222

Interoperability endpoints

  • Direct secure messaging: wesleyclarkray@hma.allscriptsdirect.net

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.

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1063403434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-2153",
            "fax_number": "629-255-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 22nd Ave N",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372031852",
            "country_code": "US",
            "telephone_number": "615-324-2149",
            "fax_number": "615-916-3862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "WESLEY",
        "middle_name": "CLARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD019992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q018215",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3065839",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.