Robert E Wray, DO

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

05-22793 Issued in KS

Practice address

810 W Bramley St
Jetmore, KS 67854-9320

Phone

(620) 357-8354

Fax

(620) 357-6460

NPI assigned

Sep 9, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15770/brand/1/csg/1/fhir/r4

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.

• Hodgeman County Health Center

  • Critical Access Hospital
  • Jetmore, KS
  • NPI 1821098252
  Medicare reassignment NPD
• Hodgeman County Health Center

  • Critical Access Hospital
  • Jetmore, KS
  • NPI 1093821514
  NPD
• Hodgeman County Health Center

  • Clinic/Center
  • Jetmore, KS
  • NPI 1790777324
  NPD
• Great Bend Regional Hospital, LLC

  • General Acute Care Hospital
  • Great Bend, KS
  • NPI 1720041684
  NPD (past)
• Great Bend Regional Hospital, LLC

  • Clinical Medical Laboratory
  • Great Bend, KS
  • NPI 1780922773
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1487648945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 MARSH AVE",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "675471129",
            "telephone_number": "620-659-2890",
            "fax_number": "620-659-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W BRAMLEY ST",
            "city": "JETMORE",
            "state": "KS",
            "postal_code": "678549320",
            "telephone_number": "620-357-8354",
            "fax_number": "620-357-6460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Marsh Ave",
            "address_purpose": "LOCATION",
            "city": "Kinsley",
            "state": "KS",
            "postal_code": "675471129",
            "country_code": "US",
            "telephone_number": "620-659-2890",
            "fax_number": "620-659-2897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRAY",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "KS",
            "license": "05-22793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230630E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Pack
• Unified School District 227
• Alejandro David Vando Pedrosa, MD
• Wildfire Chiropractic, LLC
• Janet Woods, MSN BSN RN

• Geriatric Medicine (Family Medicine) Physician in Jetmore, KS
• Providers in Jetmore, KS by specialty
• Geriatric Medicine (Family Medicine) Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.