S. Jeff Bray, DPM, Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

P157 Issued in ID

Legal business name

S. JEFF BRAY, DPM, INC.

Practice address

2240 E Center St
Pocatello, ID 83201-2600

Phone

(208) 233-2100

Fax

(208) 233-3146

NPI assigned

Jun 14, 2007

Last updated

Sep 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. S Jeff Bray, DPM

Title

President

Phone

(208) 233-2100

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1669676276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 E CENTER ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012600",
            "telephone_number": "208-233-2100",
            "fax_number": "208-233-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 E CENTER ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012600",
            "telephone_number": "208-233-2100",
            "fax_number": "208-233-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. JEFF BRAY, DPM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "S",
        "authorized_official_middle_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-233-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD9805",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010034464",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P9364",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806125200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.