Active NPI
Adrienne R Ray, O.D.
- Optometrist
- Chattanooga, TN
National Provider Identifier
1366504839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S-956-TA-546
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52212290 | Medicaid | AL |
Other names 1
- Dr. Adrienne R. Richardson
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
| License | State | Type | Specialty |
|---|---|---|---|
| OPT001886 | GA | MD | Optometrist |
| OD0000003441 | TN | MD | Optometrist |
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.