Individual provider Active NPI

Gregory Scott Ray, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Kennesaw, GA
National Provider Identifier
1174761530
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
044318 Issued in GA
Practice address
1655 Roberts Blvd NW
Medical Director, Cryolife, Inc.
Kennesaw, GA 30144-3632
Phone
(770) 419-3355
NPI assigned
Jan 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 044318 GA Primary

Addresses

Primary practice location

1655 Roberts Blvd NW
Medical Director, Cryolife, Inc.
Kennesaw, GA 30144-3632

Mailing address

1125 County Line Rd NW
Acworth, GA 30101-7824

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
044318GAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert S. Smith MD, Inc Past Accepting new patients
Robert S. Smith MD, Inc Anatomic Pathology & Clinical Pathology PastSince Apr 5, 2010 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1174761530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 COUNTY LINE RD NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 ROBERTS BLVD NW",
            "address_2": "MEDICAL DIRECTOR, CRYOLIFE, INC.",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443632",
            "telephone_number": "770-419-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "044318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.