Individual provider Active NPI

Timothy William Ray, D.C.

  • Orthopedic Chiropractor
  • Longmont, CO
National Provider Identifier
1205977030
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
1358 Issued in CO
Practice address
421 21St Ave
Suite 40
Longmont, CO 80501-1469
Phone
(303) 776-5520
Fax
(303) 776-5522
NPI assigned
Feb 12, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 1358 CO
Orthopedic Chiropractor 111NX0800X 1358 CO Primary

Addresses

Primary practice location

421 21St Ave
Suite 40
Longmont, CO 80501-1469

Mailing address

421 21St Ave
Suite 40
Longmont, CO 80501-1469
Phone (303) 776-5520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221216001698 CT Practitioner - Chiropractic 8426427253 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2261CTMDClinical Social Worker
1358COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South-West Community Health Center, Inc CurrentSince Sep 12, 2022 Accepting new patients

Locations

1020 Fairfield Ave
Bridgeport, CT 06605
Phone (203) 332-4600

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

968 Fairfield Ave
Bridgeport, CT 06605

Interoperability endpoints

  • Direct secure messaging: tray596787@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1205977030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 21ST AVE",
            "address_2": "SUITE 40",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011469",
            "telephone_number": "303-776-5520",
            "fax_number": "303-776-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 21ST AVE",
            "address_2": "SUITE 40",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011469",
            "telephone_number": "303-776-5520",
            "fax_number": "303-776-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "TIMOTHY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CO",
            "license": "1358",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CO",
            "license": "1358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.