Individual provider Active NPI

Savannah Thompson Ray, FNP-C

  • Family Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1285996306
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06864 Issued in LA
Practice address
920 Oliver Rd
Monroe, LA 71201-5702
Phone
(318) 807-6267
Fax
(318) 812-6458
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06864 LA Primary

Addresses

Primary practice location

920 Oliver Rd
Monroe, LA 71201-5702

Mailing address

130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875

Other identifiers 1

IdentifierTypeStateIssuer
2197606MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120716000570 LA Practitioner - Nurse Practitioner 1557527793 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP06864LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minden Physician Practices LLC CurrentSince Oct 19, 2023 Accepting new patients
CLHG-Ruston LLC CurrentSince Jun 26, 2023 Accepting new patients
CLHG-Ruston LLC Current Accepting new patients
Minden Physician Practices LLC CurrentSince Oct 19, 2023 Accepting new patients
Allegiance Medical Clinic of Dequincy LLC CurrentSince Aug 22, 2023 Accepting new patients
CLHG-Ruston LLC CurrentSince Jun 26, 2023 Accepting new patients
CLHG-Leesville Past Accepting new patients
CLHG-Leesville Past Accepting new patients
Minden Physician Practices LLC Family Past Accepting new patients

Locations

601 W 4th St
Dequincy, LA 70633
Phone (337) 786-6161

170 Healthcare Plaza Dr
Haughton, LA 71037
Phone (318) 382-7299

1 Medical Plaza Pl
Minden, LA 71055
Phone (318) 371-4042

346 Homer Rd
Minden, LA 71055
Phone (318) 377-4625

1111 Homer Rd
Minden, LA 71055
Phone (318) 377-7500

401 E Vaughn Ave
Ruston, LA 71270
Phone (318) 254-2100

411 E Vaughn Ave
Ste 104
Ruston, LA 71270
Phone (318) 254-2453

Interoperability endpoints

  • Direct secure messaging: savannah.ray.1@3681.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1285996306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST",
            "address_2": "SUITE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017319",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 OLIVER RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015702",
            "telephone_number": "318-807-6267",
            "fax_number": "318-812-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "SAVANNAH",
        "middle_name": "THOMPSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2197606",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.