Individual provider Active NPI

Beverly Ray, MSW

  • Clinical Social Worker
  • Mountain Home, TN
National Provider Identifier
1205960218
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4902 Issued in TN
Practice address
BLDG 52 Lake Drive
VA Medical Center
Mountain Home, TN 37684-0699
Phone
(423) 439-8000
Fax
(423) 439-2200
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 115081 CA
Clinical Social Worker 1041C0700X 61423863 WA
Clinical Social Worker 1041C0700X 4902 TN Primary
Clinical Social Worker 1041C0700X 6801085309 MI
Clinical Social Worker 1041C0700X 0904008653 VA

Addresses

Primary practice location

BLDG 52 Lake Drive
VA Medical Center
Mountain Home, TN 37684-0699

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 439-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071025000641 TN Practitioner - Clinical Social Worker 1658300330
I20260313000707 VA Practitioner - Clinical Social Worker 1658300330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

12420 Warwick Blvd
BLDG 3 Suite 4a
Newport News, VA 23606-3001
Phone (757) 594-4431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801085309MIMDClinical Social Worker
0904008653VAMDClinical Social Worker
61423863WAMDClinical Social Worker
115081CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Riverside Physician Services Inc CurrentSince Mar 11, 2026 Accepting new patients
Riverside Physician Services, Inc. CurrentSince Mar 11, 2026 Accepting new patients
Peace of Mind Therapy Services Clinical Past Accepting new patients
Wayne E. Tasker and Associates, Inc. Clinical Past Accepting new patients

Locations

12420 Warwick Blvd
Ste 4A
Newport News, VA 23606
Phone (757) 534-5509

Interoperability endpoints

  • Direct secure messaging: beverlyray@tdh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1205960218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-8000",
            "fax_number": "423-439-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 52 LAKE DRIVE",
            "address_2": "VA MEDICAL CENTER",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-8000",
            "fax_number": "423-439-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "BEVERLY",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115081",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61423863",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4902",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085309",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, TN

Sources for this page

Verify at the official NPI Registry.