P Truett Ray Jr., M.D

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD013941 Issued in LA

Practice address

504 N Acadia Rd
Thibodaux, LA 70301-4862

Phone

(985) 447-5667

Fax

(985) 447-5670

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669411773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014862",
            "telephone_number": "985-447-5667",
            "fax_number": "985-447-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014862",
            "telephone_number": "985-447-5667",
            "fax_number": "985-447-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "P",
        "middle_name": "TRUETT",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "MD013941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1333948",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4397691627A",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00065497",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ramirez, BS
• Johnnie Lynn Randolph
• Pasam Sudershan Rao, MD
• Renee Lynn Rasid, PA-C
• Jason R. Ray, DDS
• Jessica Reaux
• Danica Reaves
• Mesha Eymard Rebstock, LPC
• Iesha Reed
• Maryellen Reed, FNLP, CFNC

• Urology Physician in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Urology Physician in Louisiana

• 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.

Verify at the official NPI Registry.