NPIMap

Organization Active NPI

James Bradley Ray MD PC

  • Surgery Physician
  • Bloomington, IN
National Provider Identifier
1114019353
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01046774 Issued in IN
Legal business name
JAMES BRADLEY RAY MD PC
Practice address
822 W 1St St
Suite 7
Bloomington, IN 47403-2384
Phone
(812) 330-9962
Fax
(812) 330-9967
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
James Bradley Ray, MDNPI 1871590943
Title
Owner
Phone
(812) 330-9962

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 01046774 IN Primary

Addresses

Primary practice location

822 W 1St St
Suite 7
Bloomington, IN 47403-2384

Mailing address

502 W 2ND St
Bloomington, IN 47403-2316
Phone (812) 330-9962

Other identifiers 1

IdentifierTypeStateIssuer
200195160MedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1114019353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032316",
            "telephone_number": "812-330-9962",
            "fax_number": "812-330-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 W 1ST ST",
            "address_2": "SUITE 7",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032384",
            "telephone_number": "812-330-9962",
            "fax_number": "812-330-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES BRADLEY RAY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-330-9962",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IN",
            "license": "01046774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200195160",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.