Johnny P Ray, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA23097 Issued in FL

Practice address

4285 Lafayette St
Marianna, FL 32446-2919

Phone

(850) 482-0080

Fax

(850) 482-0082

NPI assigned

May 7, 2024

Last updated

May 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1487402376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4285 LAFAYETTE ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462919",
            "telephone_number": "850-482-0080",
            "fax_number": "850-482-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 LAFAYETTE ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462919",
            "telephone_number": "850-482-0080",
            "fax_number": "850-482-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "JOHNNY",
        "middle_name": "P",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Camille Reed
• Renal Treatment Centers-Southeast, LP. (Marianna Dialysis Center)
• Resilient Clinic, LLC

• Physical Therapy Assistant in Marianna, FL
• Providers in Marianna, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.