Individual provider Active NPI

Angela S Ray, MD

  • Emergency Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1639114697
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36433 Issued in TN
Practice address
2552 Desales Avenue
Chattanooga, TN 37404
Phone
(423) 697-0014
Fax
(423) 648-6280
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 056351 GA
Emergency Medicine Physician 207P00000X 36433 TN Primary
Emergency Medicine Physician 207P00000X 21926 SC
Emergency Medicine Physician 207P00000X 2024003709 MO

Addresses

Primary practice location

2552 Desales Avenue
Chattanooga, TN 37404

Mailing address

725 Glenwood Drive
Suite E487
Chattanooga, TN 37404
Phone (423) 697-0014

Other practice location 1

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5000

Other identifiers 6

IdentifierTypeStateIssuer
865075828BMedicaidGA
865075828EMedicaidSC
865075828AMedicaidGA
865075828MedicaidGA
10058874OtherGAAMERIGROUP
865075828CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170207001485 CA Practitioner - Emergency Medicine 5395787196 Reassigns benefits to 3 organizations
I20241007002071 MO Practitioner - Emergency Medicine 5395787196 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36433TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince May 22, 2020 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Mar 20, 2021 Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Mar 15, 2021 Accepting new patients
Sherman Oaks Emergency Medical Associates Emergency Medicine CurrentSince Feb 11, 2017 Accepting new patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine CurrentSince Dec 6, 2016 Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients
Licking Memorial Professional Corporation Past Accepting new patients
Carolina Emergency Associates Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

4929 Van Nuys Blvd
Van Nuys, CA 91403
Phone (818) 907-4561

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

725 Glenwood Dr
Ste E487
Chattanooga, TN 37404
Phone (423) 697-0014

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

923 E Central Ave
La Follette, TN 37766
Phone (423) 907-1200

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1639114697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DRIVE",
            "address_2": "SUITE E487",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 DESALES AVENUE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11133 Dunn Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366163",
            "country_code": "US",
            "telephone_number": "314-653-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "ANGELA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "056351",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "36433",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "21926",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2024003709",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "865075828B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "865075828E",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "865075828A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "865075828",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10058874",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "865075828C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.