Organization Active NPI

Tommy V. Ray Jr Inc

  • Chiropractor
  • Pine Bluff, AR
National Provider Identifier
1366643462
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1025 Issued in AR
Legal business name
TOMMY V. RAY JR INC
Practice address
3415 Camden Rd
Pine Bluff, AR 71603-9082
Phone
(870) 879-4970
Fax
(870) 879-6650
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Tommy V. Ray Jr., DC
Title
President
Phone
(870) 879-4970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1025 AR Primary

Addresses

Primary practice location

3415 Camden Rd
Pine Bluff, AR 71603-9082

Mailing address

PO Box 1306
Pine Bluff, AR 71613-1306
Phone (870) 879-4970

Other identifiers 1

IdentifierTypeStateIssuer
145987718MedicaidAR

National Provider Directory

National Provider Directory

Locations

3415 Camden Rd
Pine Bluff, AR 71603
Phone (870) 879-4970

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1366643462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1306",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716131306",
            "telephone_number": "870-879-4970",
            "fax_number": "870-879-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 CAMDEN RD",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716039082",
            "telephone_number": "870-879-4970",
            "fax_number": "870-879-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMMY V. RAY JR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-879-4970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145987718",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.