Individual provider Active NPI

Scott Logan Ray, DO

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1205464039
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
320104 Issued in NC
Practice address
1130 W Michigan St # Fh204
Indianapolis, IN 46202-5209
Phone
(317) 274-0076
Fax
(317) 274-0256
NPI assigned
Mar 28, 2020
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 320104 NC Primary

Addresses

Primary practice location

1130 W Michigan St # Fh204
Indianapolis, IN 46202-5209

Mailing address

550 S Jackson St FL Street3
Louisville, KY 40202-1622

Other practice location 1

550 S Jackson St Fl Street3
Louisville, KY 40202-1622
Phone (502) 852-5666

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241230000427 NC Practitioner - Anesthesiology 4284035411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320104NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Anesthesia Services Group Inc Anesthesiology CurrentSince Sep 16, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sray2940094@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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

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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1205464039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST FL STREET3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 W MICHIGAN ST # FH204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-274-0076",
            "fax_number": "317-274-0256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Jackson St Fl Street3",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021622",
            "country_code": "US",
            "telephone_number": "502-852-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "SCOTT",
        "middle_name": "LOGAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "320104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.