Individual provider Active NPI

Ronald Keith Wray, MD

  • Gastroenterology Physician
  • Oak Ridge, TN
National Provider Identifier
1184617649
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
23589 Issued in TN
Practice address
988 Oak Ridge Tpke
Suite 200, Physicians Plaza
Oak Ridge, TN 37830-6930
Phone
(865) 483-4366
Fax
(865) 483-5957
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 23589 TN Primary

Addresses

Primary practice location

988 Oak Ridge Tpke
Suite 200, Physicians Plaza
Oak Ridge, TN 37830-6930

Mailing address

988 Oak Ridge Tpke
Suite 200, Physicians Plaza
Oak Ridge, TN 37830-6930
Phone (865) 483-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110114000232 TN Practitioner - Gastroenterology 6406045996 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Ridge Gastroenterology Associates, PC Gastroenterology Current Accepting new patients
Covenant Medical Group, Inc CurrentSince Sep 1, 2014 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Sep 1, 2014 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

988 Oak Ridge Tpke
Ste 200
Oak Ridge, TN 37830
Phone (865) 483-4366

Organizations & group practices 3

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1184617649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE",
            "address_2": "SUITE 200, PHYSICIANS PLAZA",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306930",
            "telephone_number": "865-483-4366",
            "fax_number": "865-483-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE",
            "address_2": "SUITE 200, PHYSICIANS PLAZA",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306930",
            "telephone_number": "865-483-4366",
            "fax_number": "865-483-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "RONALD",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "23589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.