Individual provider Active NPI

Elizabeth Wray, R.D.

  • Registered Dietitian
  • Wichita, KS
National Provider Identifier
1477962231
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2041 Issued in KS
Practice address
3311 E Murdock St
Wichita, KS 67208-3054
Phone
(316) 689-9989
Fax
(316) 689-9972
NPI assigned
Aug 6, 2014
Last updated
Dec 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1065323 WY
Registered Dietitian 133V00000X 2041 KS Primary

Addresses

Primary practice location

3311 E Murdock St
Wichita, KS 67208-3054

Mailing address

PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135

Other identifiers 1

IdentifierTypeStateIssuer
830168495OtherWYVETERAN AFFAIRS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2041KSMDRegistered Dietitian
1065323WYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1477962231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 E MURDOCK ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083054",
            "telephone_number": "316-689-9989",
            "fax_number": "316-689-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "ELIZABETH",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WY",
            "license": "1065323",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "2041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERAN AFFAIRS",
            "identifier": "830168495",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.