Individual provider Active NPI

Adrienne R Ray, O.D.

  • Optometrist
  • Chattanooga, TN
National Provider Identifier
1366504839
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-956-TA-546 Issued in AL
Practice address
7200 Shallowford Rd
Chattanooga, TN 37421-2671
Phone
(423) 499-0810
Fax
(423) 805-7338
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD0000003441 TN
Optometrist 152W00000X OPT001886 GA
Optometrist 152W00000X S-956-TA-546 AL Primary

Addresses

Primary practice location

7200 Shallowford Rd
Chattanooga, TN 37421-2671

Mailing address

8107 Carriage Xing
Chattanooga, TN 37421-3265
Phone (334) 201-7226

Other identifiers 1

IdentifierTypeStateIssuer
52212290MedicaidAL

Other names 1

  • Dr. Adrienne R. Richardson Former name

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

State licenses

LicenseStateTypeSpecialty
OPT001886GAMDOptometrist
OD0000003441TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1366504839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8107 CARRIAGE XING",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213265",
            "telephone_number": "334-201-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212671",
            "telephone_number": "423-499-0810",
            "fax_number": "423-805-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ADRIENNE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000003441",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001886",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-956-TA-546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52212290",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "RICHARDSON",
            "middle_name": "R.",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.