Individual provider Active NPI

Andrew Michael Ray, AGACNP-BC

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1194504175
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5019050 Issued in NC
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 667-2606
Fax
(910) 815-5698
NPI assigned
Sep 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5019050 NC
Acute Care Nurse Practitioner 363LA2100X 5019050 NC
Adult Health Nurse Practitioner 363LA2200X 5019050 NC
Nurse Practitioner 363L00000X 5019050 NC Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 667-7260

Other practice location 1

1347 Element Way Apt 4202
Wilmington, NC 28412-1618
Phone (304) 712-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221003644 NC Practitioner - Nurse Practitioner 5991155574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-3000

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Pender Memorial Hospital Hospital, Burgaw, NC, CCN 341307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC CurrentSince May 3, 2024 Accepting new patients
Inpatient Consultants of North Carolina, PC Nurse Practitioner CurrentSince Dec 11, 2023 Accepting new patients
Inpatient Consultants of North Carolina, PC Nurse Practitioner CurrentSince Dec 11, 2023 Accepting new patients
NMG Health Services LLC CurrentSince May 3, 2024 Accepting new patients
Ncmwc, Inc CurrentSince Jul 1, 2025 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients

Locations

10089 Willow Creek Rd
Ste 200
San Diego, CA 92131
Phone (858) 621-1514

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

5540 Centerview Dr
Ste 204
Raleigh, NC 27606
Phone (704) 221-2320

179 Combs St
Sparta, NC 28675
Phone (336) 372-2441

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

3015 Enterprise Dr
Wilmington, NC 28405
Phone (910) 791-3451

Interoperability endpoints

  • Direct secure messaging: aray903068@direct.novanthealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1194504175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-667-7260",
            "fax_number": "910-815-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-2606",
            "fax_number": "910-815-5698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1347 Element Way Apt 4202",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284121618",
            "country_code": "US",
            "telephone_number": "304-712-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5019050",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5019050",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5019050",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.