Active NPI
Jack G Bray, MD
- Pain Medicine (Anesthesiology) Physician
- Overland Park, KS
National Provider Identifier
1568565042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 0422884
- Practice address
- 8800 Ballentine
Overland Park, KS 66214 - Phone
- (913) 894-0384
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 0422884 | KS | Primary |
Addresses
Primary practice location
8800 Ballentine
Overland Park, KS 66214
Mailing address
940 West Port Plaza
Ste 270
St Louis, MO 63146
Phone (314) 453-0600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1001927108 | Medicaid | KS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outpatient Anesthesia Specialists LLC | Past | Accepting new patients | |
| Anesthesia & Pain Management | Pain Medicine | Past | Accepting new patients |
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.
-
- Certified Registered Nurse Anesthetist
- Overland Park, KS
- NPI 1386747863
Pain Medicine
-
- Certified Registered Nurse Anesthetist
- Kansas City, MO
- NPI 1194828673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568565042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 WEST PORT PLAZA",
"address_2": "STE 270",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63146",
"telephone_number": "314-453-0600",
"fax_number": "314-453-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8800 BALLENTINE",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "66214",
"telephone_number": "913-894-0384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAY",
"first_name": "JACK",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "KS",
"license": "0422884",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1001927108",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.