Individual provider Active NPI

Kara Ray, RCSWI

  • Social Worker
  • Trinity, FL
National Provider Identifier
1093400012
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
12463-M Issued in GA
Practice address
3636 Galileo Dr Ste 102
Trinity, FL 34655-1852
Phone
(727) 261-0508
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12463-M GA Primary

Addresses

Primary practice location

3636 Galileo Dr Ste 102
Trinity, FL 34655-1852

Mailing address

1815 Pleasant Grove Rd
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Other practice location 1

2126 N 1st St Ste F
Jacksonville, AR 72076-2868
Phone (501) 982-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12463-MGAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Mental Health LLC CurrentSince Jan 5, 2025 Accepting new patients

Locations

3636 Galileo Dr
Ste 102
Trinity, FL 34655
Phone (727) 261-0508

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1093400012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-336-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 GALILEO DR STE 102",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551852",
            "telephone_number": "727-261-0508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2126 N 1st St Ste F",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "AR",
            "postal_code": "720762868",
            "country_code": "US",
            "telephone_number": "501-982-5000",
            "fax_number": "501-982-5007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "KARA",
        "credential": "RCSWI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "12463-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.