NPIMap

Individual provider Active NPI

Stephanie Jo Kray, M.D.

  • Family Medicine Physician
  • Staples, MN
National Provider Identifier
1114942216
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40710 Issued in MN
Practice address
49725 County 83
Staples, MN 56479-5280
Phone
(218) 894-1515
Fax
(218) 894-8767
NPI assigned
Jul 12, 2006
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40710 MN Primary

Addresses

Primary practice location

49725 County 83
Staples, MN 56479-5280

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Other identifiers 8

IdentifierTypeStateIssuer
0105822OtherMEDICA
18F30KROtherMNBCBS OF MINNESOTA
506380900MedicaidMN
A019OtherMNTRICARE
992491OtherAMERICA'S PPO
HP29219OtherHEALTH PARTNERS
151305C736OtherMNUCARE MINNESOTA
NA9231017076OtherPREFERRED ONE

Other names 1

  • Ms. Stephanie Joe Hansen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100309000578 MN Practitioner - Family Practice 9830234244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Health SystemGroup PAC ID 1052229671, shared by 15 NPIs, 107 clinicians

Practice addresses (Care Compare)

49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40710MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Health System CurrentSince Sep 3, 2019 Accepting new patients
Lakewood Health System CurrentSince Jan 6, 2026 Accepting new patients
Lakewood Health System CurrentSince Sep 3, 2019 Accepting new patients
Lakewood Health System Current Accepting new patients
Lakewood Health System Past Accepting new patients

Locations

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

Interoperability endpoints

  • Direct secure messaging: skray633950@direct.ochin.org

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 5

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1114942216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAY",
        "first_name": "STEPHANIE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0105822",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MINNESOTA",
            "identifier": "18F30KR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506380900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A019",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "992491",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP29219",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "151305C736",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9231017076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HANSEN",
            "middle_name": "JOE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staples, MN

Sources for this page

Verify at the official NPI Registry.