Lawrence James Dubray Sr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0102 Issued in SD

Practice address

South Soldier Creek Rd Hospital
Rosebud PHS IHS, SD 57570

Phone

(605) 747-2231

Fax

(605) 747-5352

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Horizon Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Plankinton, SD
  • NPI 1356459382
  Medicare reassignment
• Horizon Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Yankton, SD
  • NPI 1013445907
  NPD
• Horizon Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Mission, SD
  • NPI 1578672846
  NPD
• Horizon Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • White River, SD
  • NPI 1962511014
  NPD (past)
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1689643082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO #152",
            "city": "MISSION",
            "state": "SD",
            "postal_code": "57555",
            "telephone_number": "605-747-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTH SOLDIER CREEK RD HOSPITAL",
            "city": "ROSEBUD PHS IHS",
            "state": "SD",
            "postal_code": "57570",
            "telephone_number": "605-747-2231",
            "fax_number": "605-747-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBRAY",
        "first_name": "LAWRENCE",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.