Gina Vick Bray, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15380 Issued in MS

Practice address

187 Stateline Rd E
Suite 10
Southaven, MS 38671-1704

Phone

(662) 342-5353

Fax

(662) 393-9753

NPI assigned

Jul 7, 2005

Last updated

Apr 14, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, TN, IL3 enrollments

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 3

Specialty

Internal Medicine

Education

West Virginia School of Osteopathic Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Statera Health Care LLCGroup PAC ID 0244565729, 41 clinicians

Correct Care, Inc.Group PAC ID 8628980992, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tyler Holmes Memorial Hospital Cah Hospital, Winona, MS, CCN 251312
• Massac Memorial Hospital Hospital, Metropolis, IL, CCN 141323
• Ochsner Choctaw General Hospital, Butler, AL, CCN 011304
• South Sunflower County Hospital Hospital, Indianola, MS, CCN 250095
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/allihcs-9d312177
• FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9

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.

• Correct Care, Inc.

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1215987441

  MS

  Medicare reassignment Care Compare group NPD
• Statera Health Care, LLC

  • Emergency Medicine Physician
  • Harrisburg, IL
  • NPI 1043874449
  Medicare reassignment Care Compare group NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Medicare reassignment NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  dba Monroe Regional Hospital

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  Medicare reassignment NPD
• Independent Healthcare Management, Inc.

  dba S E Lackey Memorial Hospital

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Medicare reassignment NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment NPD
• Carr PLLC

  dba Sound Physicians Emergency of Greater Memphis

  • Emergency Medicine Physician
  • Brentwood, TN
  • NPI 1548677610

  MS

  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610

  TN

  Medicare reassignment NPD
• Hardin Emergency Group LLC

  • Emergency Medicine Physician
  • Savannah, TN
  • NPI 1972850477
  Medicare reassignment NPD
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Emergency Care Clinic/Center
  • Ripley, TN
  • NPI 1962034272
  Medicare reassignment NPD
• Putnam Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Cookeville, TN
  • NPI 1891475752
  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  MS

  Medicare reassignment NPD

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

• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation
• South Sunflower County Hospital

  • General Acute Care Hospital
  • Indianola, MS
  • NPI 1184679292
  Care Compare affiliation
• Tyler Holmes Memorial Hospital

  • Critical Access Hospital
  • Winona, MS
  • NPI 1205868627
  Care Compare affiliation
• Massac Memorial Hospital

  • Critical Access Hospital
  • Metropolis, IL
  • NPI 1790788578
  Care Compare affiliation
• Rush Hospital/Butler, Inc

  dba Ochsner Choctaw General

  • Critical Access Hospital
  • Butler, AL
  • NPI 1184993727
  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1255338984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1369",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386710014",
            "telephone_number": "662-342-5353",
            "fax_number": "662-393-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 STATELINE RD E",
            "address_2": "SUITE 10",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711704",
            "telephone_number": "662-342-5353",
            "fax_number": "662-393-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "GINA",
        "middle_name": "VICK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarad Joseph Braddy, D.D.S.
• John Mark Bradford, R.PH.
• Bradley S Thompson Family Limited Partnership No One
• Emma Bradley, PMHNP-BC
• Mackenzie Eryn Brannan, PT
• Samuel Breite
• William E. Brent, RPH
• Herbert Leon Brewer III, DC
• Brian Shwer, DPM (Southaven Foot Clinic)
• Brian Shwer, DPM

• Internal Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.