Individual provider Active NPI

Jessica Lynn Bray, ANP-C

  • Nurse Practitioner
  • Coeur d'Alene, ID
National Provider Identifier
1104590751
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9181316 Issued in ID
Practice address
700 W Ironwood Dr Ste 350
Coeur D Alene, ID 83814-4487
Phone
(208) 625-5222
Fax
(208) 625-5223
NPI assigned
Aug 6, 2021
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9181316 ID Primary
Nurse Practitioner 363L00000X 182046 AK

Addresses

Primary practice location

700 W Ironwood Dr Ste 350
Coeur D Alene, ID 83814-4487

Mailing address

700 W Ironwood Dr Ste 350
Coeur D Alene, ID 83814-4487
Phone (208) 625-5222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.bray.1@2839.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211012001511 AK Practitioner - Nurse Practitioner 4688072234 Reassigns benefits to 3 organizations
I20260626004811 ID Practitioner - Nurse Practitioner 4688072234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alyeska Vascular Surgery, LLCGroup PAC ID 2567610181, 14 clinicians

Practice addresses (Care Compare)

4001 Laurel St
Suite 204
Anchorage, AK 99508-5300
Phone (907) 562-8346

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
182046AKMDNurse Practitioner
9181316IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mat-Su Valley III LLC Current Accepting new patients
Mat-Su Valley Medical Center LLC CurrentSince Jul 5, 2021 Accepting new patients
Alyeska Vascular Surgery LLC CurrentSince Dec 2, 2024 Accepting new patients
Mat-Su Valley III LLC CurrentSince Jul 5, 2021 Accepting new patients
Mat-Su Valley III LLC CurrentSince Jul 5, 2021 Accepting new patients
Mat Su Valley Medical Center LLC CurrentSince Jul 5, 2021 Accepting new patients
Alaska Imaging Associates, LLC Past Accepting new patients

Locations

2751 Debarr Rd
#328
Anchorage, AK 99508
Phone (907) 562-8346

4001 Laurel St
Ste 204
Anchorage, AK 99508
Phone (907) 561-1426

2480 S Woodworth Loop
Ste 120
Palmer, AK 99645

2490 S Woodworth Loop
Ste 200
Palmer, AK 99645
Phone (907) 746-7747

2490 S Woodworth Loop
Ste 250
Palmer, AK 99645
Phone (907) 861-6700

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

950 E Bogard Rd
Wasilla, AK 99654
Phone (907) 352-2880

950 E Bogard Rd
Ste 207
Wasilla, AK 99654
Phone (907) 357-9444

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ALYVAS
  • Direct secure messaging: jessica.bray.1@2839.direct.athenahealth.com

Organizations & group practices 8

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 1

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": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1104590751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 350",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144487",
            "telephone_number": "208-625-5222",
            "fax_number": "208-625-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 350",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144487",
            "telephone_number": "208-625-5222",
            "fax_number": "208-625-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "9181316",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "182046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.bray.1@2839.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "2490 S Woodworth Loop Ste 250",
            "city": "Palmer",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996457407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.