Shanon Robert Ray, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3582 Issued in MN

Practice address

418 Demers Ave
East Grand Forks, MN 56721-1836

Phone

(218) 773-8403

Fax

(218) 773-9812

NPI assigned

Nov 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ray Chiropractic PA

  • Chiropractor
  • East Grand Forks, MN
  • NPI 1811076086
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1164603833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211836",
            "telephone_number": "218-773-8403",
            "fax_number": "218-773-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211836",
            "telephone_number": "218-773-8403",
            "fax_number": "218-773-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "SHANON",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "22582",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086882400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12129",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "71D82RA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelina Pylka, MS, LPCC
• Mayuresh Rajaratnam, MD
• Tiffany Ramirez
• Adaire Ranstrom, MT-BC
• Ray Chiropractic PA
• Red River Dental Clinic LTD
• Red River Plastic Surgery Center
• Jerald W Reinhardt, MD
• Andrew Reiter
• Christlie A Rene

• Chiropractor in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.