Individual provider Active NPI

Courtney Anne Ray, FNP-BC

  • Family Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1538932280
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028306 Issued in CA
Practice address
77 Casa St
San Luis Obispo, CA 93405-5803
Phone
(661) 695-8385
NPI assigned
Nov 3, 2023
Last updated
Dec 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95041544 CA
Family Nurse Practitioner 363LF0000X 95028306 CA Primary

Addresses

Primary practice location

77 Casa St
San Luis Obispo, CA 93405-5803

Mailing address

341 W Magill Ave
Clovis, CA 93612-0258
Phone (559) 213-7218

Other identifiers 1

IdentifierTypeStateIssuer
95028306OtherCACALIFORNIA BRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240124000333 CA Practitioner - Nurse Practitioner 0547612723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rheumatology Services Medical GroupGroup PAC ID 2264685270, 9 clinicians

Practice addresses (Care Compare)

77 Casa St
Suite 101
San Luis Obispo, CA 93405-5804
Phone 6616958385118

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95041544CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology Services Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Rheumatology Services Medical Group PastSince Jan 1, 2024 Accepting new patients

Locations

3737 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (661) 327-5037

8329 Brimhall Rd
Ste 801
Bakersfield, CA 93312
Phone (661) 695-8385

77 Casa St
Ste 101
Sn Luis Obisp, CA 93405
Phone (661) 695-8385

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCEGAA

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1538932280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 W MAGILL AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120258",
            "telephone_number": "559-213-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "661-695-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95041544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BRN",
            "identifier": "95028306",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.