Individual provider Active NPI

Mary Louise Hudson Ray, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Sebring, FL
National Provider Identifier
1669804258
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9206365 Issued in FL
Practice address
2821 Alt US Hwy 27 S
Sebring, FL 33870
Phone
(863) 385-6374
Fax
(863) 385-3482
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9206365 FL Primary

Addresses

Primary practice location

2821 Alt US Hwy 27 S
Sebring, FL 33870

Mailing address

2821 Alt US Hwy 27 S
Sebring, FL 33870-4972
Phone (863) 382-3914

Other identifiers 1

IdentifierTypeStateIssuer
009600800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130912000070 FL Practitioner - Nurse Practitioner 5092959155 Reassigns benefits to 2 organizations
I20240221000263 AL Practitioner - Nurse Practitioner 5092959155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Behavioral Health Inc 109 clinicians

Practice addresses (Care Compare)

7101 US Hwy 90
Suite 103
Daphne, AL 36526-9510
Phone (251) 517-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9206365FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health, Inc. Psychiatric/Mental Health CurrentSince Dec 19, 2023 Accepting new patients
Che Behavioral Health Services of Florida, P.a. Psychiatric/Mental Health CurrentSince Mar 1, 2021 Accepting new patients

Locations

7101 US Highway 90
Ste 103
Daphne, AL 36526
Phone (251) 517-5800

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

Organizations & group practices 3

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1669804258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 ALT US HWY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338704972",
            "telephone_number": "863-382-3914",
            "fax_number": "863-402-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 ALT US HWY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-385-6374",
            "fax_number": "863-385-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MARY LOUISE",
        "middle_name": "HUDSON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9206365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009600800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.