Individual provider Active NPI

Ian Jameson Ray

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1164041893
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26026693A Issued in IN
Practice address
5555 Michigan Rd
Indianapolis, IN 46228-2219
Phone
(317) 287-0427
Fax
(317) 287-0427
NPI assigned
Apr 13, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
26026693AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Apr 19, 2020 Accepting new patients
Wal-Mart Stores East, LP PastSince Apr 19, 2020 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26026693A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

5555 Michigan Rd
Indianapolis, IN 46228-2219

Mailing address

5960 Richmond LN
Indianapolis, IN 46254-1067
Phone (317) 361-7530

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 13, 2020.

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1164041893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5960 RICHMOND LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541067",
            "telephone_number": "317-361-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 MICHIGAN RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462282219",
            "telephone_number": "317-287-0427",
            "fax_number": "317-287-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "IAN",
        "middle_name": "JAMESON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26026693A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.