Active NPI
Kattie Ray, RN
- Registered Nurse
- Middleburg, FL
National Provider Identifier
1508234949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN 9404675
- Practice address
- 3292 County Road 220
Middleburg, FL 32068-4357 - Phone
- (904) 291-5561
- Fax
- (904) 291-5575
- NPI assigned
- Sep 2, 2015
- Last updated
- Sep 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN 9404675 | FL | Primary |
Addresses
Primary practice location
3292 County Road 220
Middleburg, FL 32068-4357
Mailing address
1726 Kingsley Ave Ste 2
Orange Park, FL 32073-4411
Phone (904) 278-5644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 940675 | Medicaid | FL |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN 9404675 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1508234949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 KINGSLEY AVE STE 2",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734411",
"telephone_number": "904-278-5644",
"fax_number": "904-278-5659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3292 COUNTY ROAD 220",
"city": "MIDDLEBURG",
"state": "FL",
"postal_code": "320684357",
"telephone_number": "904-291-5561",
"fax_number": "904-291-5575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "KATTIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN 9404675",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "940675",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middleburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.