Individual provider Active NPI

Kristin Ray, DO

  • Family Medicine Physician
  • Rome, GA
National Provider Identifier
1548848641
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
99962 Issued in GA
Practice address
28 John Davenport Dr NW
Rome, GA 30165-2536
Phone
(706) 291-0584
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 99962 GA Primary

Addresses

Primary practice location

28 John Davenport Dr NW
Rome, GA 30165-2536

Mailing address

304 Shorter Ave NW Ste 201
Rome, GA 30165-4256
Phone (706) 509-3300

Other practice location 1

304 Shorter Ave NW Ste 201
Rome, GA 30165-4256
Phone (706) 509-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20240717003362 GA Practitioner - Family Practice 9931644697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

1328 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-4221
Phone (770) 382-0029

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Rome, GA, CCN 117010
  • Coosa Valley Home Health, an Amedisys Home health agency, Rome, GA, CCN 117041
  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

1328 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 382-0029

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

304 Shorter Ave NW
Ste 201
Rome, GA 30165
Phone (706) 509-3300

28 John Davenport Dr NW
Rome, GA 30165
Phone (706) 232-1503

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

Interoperability endpoints

  • Direct secure messaging: kray913896@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1548848641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SHORTER AVE NW STE 201",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301654256",
            "telephone_number": "706-509-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 JOHN DAVENPORT DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652536",
            "telephone_number": "706-291-0584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 Shorter Ave NW Ste 201",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301654256",
            "country_code": "US",
            "telephone_number": "706-509-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "99962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.