NPIMap

Organization Active NPI

Wray Community District Hospital

Doing business as The Wray Clinic

  • General Practice Physician
  • Wray, CO
National Provider Identifier
1477587202
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WRAY COMMUNITY DISTRICT HOSPITAL
Doing business as
The Wray Clinic
Practice address
1017 W 7TH St
Wray, CO 80758-1420
Phone
(970) 332-4895
Fax
(970) 332-3235
NPI assigned
Jul 10, 2006
Last updated
Sep 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
John Hart
Title
Ceo
Phone
(970) 332-2203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1017 W 7TH St
Wray, CO 80758-1420

Mailing address

1017 W 7TH Street
Wray, CO 80758-1420
Phone (970) 332-4895

Other identifiers 1

IdentifierTypeStateIssuer
90925769MedicaidCO

Other names 1

  • The Wray Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://urldefense.com/v3/__https:/linkprotect.cudasvc.com/url?a=https*3a*2f*2fesmd2.ssigroup.com*3a8291*2fGateway*2fDocumentSubmission*2f2_0*2fNhinService*2fXDRRequest_Service&c=E,1,BsEm99sSif1B2dbhzUiePvcRCvX6tV3YIb7zaPfrMqz4XZVa-OH-pyOTmxjK_YZJ7HKVLwR7MPSwt1IysWwcjhsrbcaFZdrfyFvU1zYo7kn3_3nkJa0-XL3_Yw,,&typo=1__;JSUlJSUlJSUl!!IPetXT4!2V498XSZME80TjP3OESWcO2YSCT9nbeFTO1uUeP1z63iUac_XM4BwY7_IyFDW3ml9DffKTRjOQbyxmL6wSl4VNHc$ Other The SSI Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040326000383 CO Part B Supplier - Clinic/Group Practice 3274425038 Receives reassigned benefits from 62 practitioners
2 other NPIs on this enrollment
Practice locations: Wray, CO
O20161220001701 CO Part A Provider - Critical Access Hospital 3274425038 Receives reassigned benefits from 45 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wray, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477587202. Details of each certification follow.

Hospital certification: CCN 061309

Legal name
WRAY COMMUNITY DISTRICT HOSPITAL
Doing business as
WRAY COMMUNITY DISTRICT HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2001
Last certification
Jul 27, 2023
Beds
15
Ownership / control type
Hospital district or authority
Organization structure
OtherProprietary
Enrollment address
1017 W 7TH St
Wray, CO 80758-1420
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Wray Community District HospitalCCN 061309 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: davidreed@wrayhospital.cernerdirect.com
  • Direct secure messaging: lindseypaulson@wrayhospital.cernerdirect.com
  • Direct secure messaging: skrautkramer@wrayhospital.cernerdirect.com
  • Direct secure messaging: susankasza@wrayhospital.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John H Everett Individual Corporate OfficerCfo Dec 1, 2024
Operational/Managerial ControlCfo Dec 1, 2024
James Hendrix Individual Corporate DirectorBoard Member Jul 30, 2019
John S Hart Individual Corporate OfficerChief Executive Officer Jan 7, 2019
Operational/Managerial ControlCeo Jan 7, 2019
Craig Soehner Individual Corporate DirectorBoard Member May 27, 2014
Wray Community District Hospital Organization, Wray, CO Non-profit Operational/Managerial Control Jan 4, 2016
Jennifer Kramer Individual Corporate OfficerChief Clinical Officer Aug 28, 2024
Operational/Managerial ControlChief Clinical Officer Aug 28, 2024
Jeffrey Wingfield Individual Corporate DirectorBoard Member May 5, 2020

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wray Community District HospitalWray, CO, CCN 06Z309 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1994
Jan 1, 1994
Wray Community District HospitalWray, CO, CCN 061309 Hospital Operational/Managerial Control Jan 4, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

Affiliated clinicians 47

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1477587202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W 7TH STREET",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4895",
            "fax_number": "970-332-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4895",
            "fax_number": "970-332-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRAY COMMUNITY DISTRICT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-332-2203"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90925769",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://urldefense.com/v3/__https:/linkprotect.cudasvc.com/url?a=https*3a*2f*2fesmd2.ssigroup.com*3a8291*2fGateway*2fDocumentSubmission*2f2_0*2fNhinService*2fXDRRequest_Service&c=E,1,BsEm99sSif1B2dbhzUiePvcRCvX6tV3YIb7zaPfrMqz4XZVa-OH-pyOTmxjK_YZJ7HKVLwR7MPSwt1IysWwcjhsrbcaFZdrfyFvU1zYo7kn3_3nkJa0-XL3_Yw,,&typo=1__;JSUlJSUlJSUl!!IPetXT4!2V498XSZME80TjP3OESWcO2YSCT9nbeFTO1uUeP1z63iUac_XM4BwY7_IyFDW3ml9DffKTRjOQbyxmL6wSl4VNHc$",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1340.1",
            "affiliationName": "The SSI Group, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "4721 Morrison Dr Ste 100",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366093350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Wray Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Wray Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wray, CO

Sources for this page

Verify at the official NPI Registry.