NPIMap

Individual provider Active NPI

Sheree A Bray, M.D., FACS

  • Trauma Surgery Physician
  • Johnson City, TN
National Provider Identifier
1396061560
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
0000055916 Issued in TN
Practice address
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone
(423) 431-6111
NPI assigned
Apr 13, 2010
Last updated
Jul 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101260274 VA
Trauma Surgery Physician 2086S0127X 0000055916 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Johnson City, TN 37604-6035

Mailing address

PO Box 70575
Department of Surgery
Johnson City, TN 37614-1708
Phone (423) 439-6268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170816003251 TN Practitioner - General Surgery 3870711286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Eastern Virginia Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 N State of Franklin Rd
Suite 130
Johnson City, TN 37604-6972
Phone (423) 431-2477

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101260274VAMDSurgery Physician
0000055916TNMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Oct 15, 2019 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Wellmont Medical Associates Inc Surgery CurrentSince Sep 1, 2017 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Oct 15, 2019 Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation Surgery Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 323-6900

410 N State of Franklin Rd
Ste 130
Johnson City, TN 37604
Phone (423) 431-2460

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1396061560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70575",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141708",
            "telephone_number": "423-439-6268",
            "fax_number": "423-439-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "SHEREE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D., FACS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101260274",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TN",
            "license": "0000055916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.