Individual provider Active NPI

Marianne C Ray, MD

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1457580060
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-36636 Issued in KS
Practice address
1916 Grand Blvd
Kansas City, MO 64108-1803
Phone
(913) 297-7472
Fax
(816) 527-0171
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-36636 KS Primary

Addresses

Primary practice location

1916 Grand Blvd
Kansas City, MO 64108-1803

Mailing address

1916 Grand Blvd
Kansas City, MO 64108-1803
Phone (913) 297-7472

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MRay13@centerwell.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140522001074 KS Practitioner - Family Practice 4486877313 Reassigns benefits to 1 organization
I20220419001211 MO Practitioner - Family Practice 4486877313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Miami, LM Miller School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerwell Senior Primary Care Mo PCGroup PAC ID 1254744469, 31 clinicians
Centerwell Senior Primary Care KS PAGroup PAC ID 6002230349, 20 clinicians

Practice addresses (Care Compare)

301 E Armour Blvd
Suite 2East
Kansas City, MO 64111-1245
Phone (816) 394-2082

7527 State Ave
Kansas City, KS 66112-2815
Phone (913) 335-6986

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-36636KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care KS PA Family Medicine CurrentSince Apr 11, 2022 Accepting new patients
Centerwell Senior Primary Care (Mo) PC Family Medicine CurrentSince Apr 11, 2022 Accepting new patients
Centerwell Senior Primary Care (Mo) PC Family Medicine CurrentSince Apr 11, 2022 Accepting new patients
Centerwell Senior Primary Care KS PA Family Medicine CurrentSince Apr 11, 2022 Accepting new patients

Locations

7527 State Ave
Kansas City, KS 66112
Phone (913) 335-6986

16575 W 119th St
Olathe, KS 66061
Phone (913) 815-5008

1513 Main St
Grandview, MO 64030
Phone (816) 731-1890

19401 E 39th St S
Independence, MO 64057
Phone (816) 490-4277

Interoperability endpoints

  • Direct secure messaging: marianne.ray@centerwell.eclinicaldirectplus.com
  • Direct secure messaging: mray13@centerwell.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1457580060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 GRAND BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081803",
            "telephone_number": "913-297-7472",
            "fax_number": "816-527-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 GRAND BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081803",
            "telephone_number": "913-297-7472",
            "fax_number": "816-527-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MARIANNE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-36636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MRay13@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1916 Grand Blvd",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641081803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.