Individual provider Active NPI

Judith L. Ray, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1669453643
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
033611 Issued in NC
Practice address
145 Kimel Park Dr Ste 120
Winston Salem, NC 27103
Phone
(336) 768-3212
Fax
(336) 768-9019
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 058311 NC
Certified Registered Nurse Anesthetist 367500000X 033611 NC Primary

Addresses

Primary practice location

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103

Mailing address

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983
Phone (336) 768-3212

Other practice location 1

117 E. Kings Highway
Eden, NC 27288-5201
Phone (336) 623-9711

Other practice location 2

117 E. Kings Highway
Eden, NC 27288-5201
Phone (336) 623-9711

Other identifiers 2

IdentifierTypeStateIssuer
8050072MedicaidNC
260054QOtherNCPSC MEDICARE PROVIDER #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JRAY145204@DIRECT.NOVANTHEALTH.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040820000253 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901870518 Reassigns benefits to 15 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Park Hospital LLCGroup PAC ID 4880595958, 109 clinicians
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-0600

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
033611NCMDCertified Registered Nurse Anesthetist
058311NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Stone Center PLLC CurrentSince Jan 1, 2006 Accepting new patients
Brunswick Community Hospital, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Current Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Mar 1, 2020 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Mar 1, 2021 Accepting new patients
Medical Park Hospital LLC CurrentSince Mar 1, 2020 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Mint Hill Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Current Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Piedmont Triad Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Jul 20, 2004 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince May 6, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Thomasville Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince May 6, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Current Accepting new patients
Medical Park Hospital LLC CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

14215 Ballantyne Corporate Pl
Ste 210
Charlotte, NC 28277
Phone (704) 316-2650

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

7210 Village Medical Cir
Ste 235
Clemmons, NC 27012
Phone (336) 893-3100

117 E Kings Hwy
Eden, NC 27288
Phone (336) 627-6181

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1730 Kernersville Medical Pkwy
Ste 304
Kernersville, NC 27284
Phone (336) 515-7000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

145 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-1770

1907 S Hawthorne Rd
#103104
Winston Salem, NC 27103

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

1907 S Hawthorne Rd
Winston Salem, NC 27103

Interoperability endpoints

  • Direct secure messaging: jray145204@direct.novanthealth.org

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 1

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1669453643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 E. Kings Highway",
            "address_purpose": "LOCATION",
            "city": "Eden",
            "state": "NC",
            "postal_code": "272885201",
            "country_code": "US",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 E. Kings Highway",
            "address_purpose": "LOCATION",
            "city": "Eden",
            "state": "NC",
            "postal_code": "272885201",
            "country_code": "US",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "JUDITH",
        "middle_name": "L.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "058311",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "033611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050072",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSC MEDICARE PROVIDER #",
            "identifier": "260054Q",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JRAY145204@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "117 E. Kings Highway",
            "city": "Eden",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272885201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.