Individual provider Active NPI

John Michael Fray, PH.D.

  • Clinical Psychologist
  • Fredericksburg, VA
National Provider Identifier
1346237062
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
871 Issued in VA
Practice address
24 Tally Ho Dr
Fredericksburg, VA 22405-3307
Phone
(540) 899-7762
Fax
(540) 899-3733
NPI assigned
Sep 29, 2005
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 871 VA Primary

Addresses

Primary practice location

24 Tally Ho Dr
Fredericksburg, VA 22405-3307

Mailing address

PO Box 7242
Fredericksburg, VA 22404-7242
Phone (540) 899-7762

Other identifiers 2

IdentifierTypeStateIssuer
066918OtherVAANTHEM PROVIDER NUMBER
186949OtherVAVALUEOPTIONS PROVIDER NUM

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1346237062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7242",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224047242",
            "telephone_number": "540-899-7762",
            "fax_number": "540-899-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 TALLY HO DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224053307",
            "telephone_number": "540-899-7762",
            "fax_number": "540-899-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "066918",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS PROVIDER NUM",
            "identifier": "186949",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.