Active NPI
Kendall S. Ray, RD
- Registered Dietitian
- Fort Wayne, IN
National Provider Identifier
1144694464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37002622A
- Practice address
- 7900 W Jefferson Blvd
Suite 201
Fort Wayne, IN 46804-4128 - Phone
- (260) 432-2297
- Fax
- (260) 969-7266
- NPI assigned
- Nov 24, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 37002622A | IN | Primary |
Addresses
Primary practice location
7900 W Jefferson Blvd
Suite 201
Fort Wayne, IN 46804-4128
Mailing address
6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Barb Copeland
Fort Wayne, IN 46804-7934
Phone (260) 479-3514
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37002622A | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483228800000",
"number": "1144694464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3514",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 W JEFFERSON BLVD",
"address_2": "SUITE 201",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044128",
"telephone_number": "260-432-2297",
"fax_number": "260-969-7266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "KENDALL",
"middle_name": "S.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-24",
"last_updated": "2017-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37002622A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.