Individual provider Active NPI

Ruth Ellen Gray

  • Chiropractor
  • Nipomo, CA
National Provider Identifier
1285655654
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 17933 Issued in CA
Practice address
150 Tejas PL
Nipomo, CA 93444-9123
Phone
(805) 929-3211
NPI assigned
Jul 21, 2006
Last updated
Jun 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 17933 CA Primary

Addresses

Primary practice location

150 Tejas PL
Nipomo, CA 93444-9123

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8028

Other identifiers 5

IdentifierTypeStateIssuer
FHC03884FMedicaidCA
1376560151OtherCAGUADALUPE NPI
1841217866OtherCANCMC NPI
W1508OtherMEDICARE GROUP NUMBER
1447277355OtherCACHCCC, SANTA MARIA 1

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720001314 CA Practitioner - Chiropractic 1557341708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Tejas PL
Nipomo, CA 93444-9123
Phone (805) 929-3211

2800 Riverside Ave
Suite 101
Paso Robles, CA 93446-1312
Phone (805) 929-3211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 17933CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Dec 21, 2011 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Dec 21, 2011 Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

1551 Bishop St
Ste 240
Sn Luis Obisp, CA 93401
Phone (805) 434-1038

1551 Bishop St
Ste A160
Sn Luis Obisp, CA 93401
Phone (805) 781-4230

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

Interoperability endpoints

  • Direct secure messaging: ruth.gray.1@17363.direct.athenahealth.com

Organizations & group practices 5

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1285655654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8028",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 TEJAS PL",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449123",
            "telephone_number": "805-929-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "RUTH",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 17933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03884F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUADALUPE NPI",
            "identifier": "1376560151",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCMC NPI",
            "identifier": "1841217866",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "W1508",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHCCC, SANTA MARIA 1",
            "identifier": "1447277355",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nipomo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.