Active NPI
Kathryn Nicole Wray, M.D.
- Pediatrics Physician
- Dallas, TX
National Provider Identifier
1679935357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- S2369
- Practice address
- 7859 Walnut Hill LN Ste 200
Dallas, TX 75230-5637 - Phone
- (214) 369-7661
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | S2369 | TX | Primary |
Addresses
Primary practice location
7859 Walnut Hill LN Ste 200
Dallas, TX 75230-5637
Mailing address
7859 Walnut Hill LN Ste 200
Dallas, TX 75230-5637
Phone (214) 369-7661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679935357 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S2369 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates of Dallas | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644192000000",
"number": "1679935357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7859 WALNUT HILL LN STE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752305637",
"telephone_number": "214-369-7661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7859 WALNUT HILL LN STE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752305637",
"telephone_number": "214-369-7661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRAY",
"first_name": "KATHRYN",
"middle_name": "NICOLE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "TX",
"license": "S2369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679935357",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.