Individual provider Active NPI

Keith E Ray, DPH

  • Pharmacist
  • Sparta, TN
National Provider Identifier
1265920532
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6308 Issued in TN
Practice address
202 Sam Walton Dr
Sparta, TN 38583-8810
Phone
(931) 738-3340
Fax
(931) 738-8558
NPI assigned
Apr 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6308 TN Primary

Addresses

Primary practice location

202 Sam Walton Dr
Sparta, TN 38583-8810

Mailing address

202 Sam Walton Dr
Sparta, TN 38583-8810
Phone (931) 738-3340

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

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1265920532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 SAM WALTON DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385838810",
            "telephone_number": "931-738-3340",
            "fax_number": "931-738-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SAM WALTON DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385838810",
            "telephone_number": "931-738-3340",
            "fax_number": "931-738-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "6308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.