Individual provider Active NPI

Thomas J Ray, C.P., B.O.C.O

  • Specialist
  • Chapel Hill, NC
National Provider Identifier
1255471405
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
CP003475 Issued in NC
Practice address
400 Meadowmont Village Cir
Suite 425
Chapel Hill, NC 27517-7505
Phone
(919) 929-5550
Fax
(919) 929-5572
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CP003475 NC Primary
Specialist 174400000X C50369 NC

Addresses

Primary practice location

400 Meadowmont Village Cir
Suite 425
Chapel Hill, NC 27517-7505

Mailing address

400 Meadowmont Village Cir
Suite 425
Chapel Hill, NC 27517-7505
Phone (919) 929-5550

Other identifiers 1

IdentifierTypeStateIssuer
7795243MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C50369NCMDSpecialist
CP003475NCMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1255471405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEADOWMONT VILLAGE CIR",
            "address_2": "SUITE 425",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275177505",
            "telephone_number": "919-929-5550",
            "fax_number": "919-929-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEADOWMONT VILLAGE CIR",
            "address_2": "SUITE 425",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275177505",
            "telephone_number": "919-929-5550",
            "fax_number": "919-929-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "C.P., B.O.C.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "CP003475",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "C50369",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7795243",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.