Individual provider Active NPI

Sean Francis Bray, PA-C

  • Physician Assistant
  • Clarksville, TN
National Provider Identifier
1477594679
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00860 Issued in TN
Practice address
651 Dunlop LN
Clarksville, TN 37040-5015
Phone
(931) 502-1370
NPI assigned
Jun 9, 2006
Last updated
Jul 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00860 TN Primary

Addresses

Primary practice location

651 Dunlop LN
Clarksville, TN 37040-5015

Mailing address

2020 21St Ave S
Suite 201
Nashville, TN 37212-4354
Phone (615) 269-0652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000308 TN Practitioner - Physician Assistant 9234107392 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
860TNMDOccupational Therapist
00860TNMDPhysician Assistant
TC030KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Magpie Emergency Physicians PLLC Physician Assistant Past Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Physician Assistant Past Accepting new patients
Emergency Physicians of Hopkinsville PLLC Past Accepting new patients
Emergency Services Network, PLLC. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sean.bray.1@32073.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1477594679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 21ST AVE S",
            "address_2": "SUITE 201",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124354",
            "telephone_number": "615-269-0652",
            "fax_number": "615-269-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405015",
            "telephone_number": "931-502-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "SEAN",
        "middle_name": "FRANCIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "00860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.