Kathryn Michele Wray, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4379 Issued in AZ

Practice address

200 Veterans Ave
Beckley, WV 25801-6444

Phone

(304) 255-2121

Fax

(304) 256-5483

NPI assigned

Oct 28, 2008

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

Other names 1

• Miss Kathryn Michele Stanley Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Navajo Health Foundation-Sage Memorial Hospital, Inc.

  • Rural Acute Care Hospital
  • Ganado, AZ
  • NPI 1477735777
  Medicare reassignment
• Navajo Health Foundation-Sage Memorial Hospital Inc

  • Critical Access Hospital Clinic/Center
  • Ganado, AZ
  • NPI 1518957398
  NPD

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1346493970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 OSPREY RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013684",
            "telephone_number": "928-279-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VETERANS AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016444",
            "telephone_number": "304-255-2121",
            "fax_number": "304-256-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "KATHRYN",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414740",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "STANLEY",
            "middle_name": "MICHELE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marissa Workman, DPT
• Melissa Workman
• Misty Workman
• Shewana C Workman, CRNA
• Teresa M Workman, FNP-BC
• Alexis Wright
• Austin Tyler Wright, D.D.S.
• Chermette Wright, MSW
• Gary Edwin Wright
• Cassey Wriston

• Physician Assistant in Beckley, WV
• Providers in Beckley, WV by specialty
• Physician Assistant in West Virginia

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