Kirsten Nicole Bray, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200100315 Issued in NC

Practice address

1617 W Garrison Blvd
Gastonia, NC 28052-3635

Phone

(704) 867-0219

Fax

(704) 867-0216

NPI assigned

Oct 7, 2005

Last updated

Jun 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hope Mills Urgent Care & Medical Clinic, PLLC

  • Internal Medicine Physician
  • Hope Mills, NC
  • NPI 1114134293

  Family Medicine

  Medicare reassignment NPD
• Windsor Point Inc.

  • Skilled Nursing Facility
  • Fuquay Varina, NC
  • NPI 1346210291
  NPD
• Hope Medical Care

  • Family Medicine Physician
  • Snow Hill, NC
  • NPI 1013153121
  NPD (past)
• Sovran Senior Living, LLC

  dba Waylin Life Care Center

  • Assisted Living Facility
  • Mount Olive, NC
  • NPI 1508134685
  NPD (past)

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1275521809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98313",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276248313",
            "telephone_number": "919-845-0054",
            "fax_number": "919-845-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 W GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280523635",
            "telephone_number": "704-867-0219",
            "fax_number": "704-867-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "KIRSTEN",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200100315",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NC",
            "license": "2001-00315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910429",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maysen Alvarez Bratbo, MS, GC
• Thandi Brathwaite
• Anita Bratton, LPPA
• Braxton Balanced Nutrition, LLC
• Rachel McClure Braxton, RD, LDN
• Logan Rhyne Breakfield, FNP
• Heather Addison Breese, LPC
• Laura Elizabeth Brentnell
• Gayle S Brezicki, COTA/L
• Bridgebuilders

• Family Medicine Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.