NPIMap

Organization Active NPI

Dr Tara F Ray Psychiatric Servcies, PLLC

  • Psychiatry Physician
  • South Charleston, WV
National Provider Identifier
1710183504
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2117 Issued in WV
Legal business name
DR TARA F RAY PSYCHIATRIC SERVCIES, PLLC
Practice address
400 Division St
Suite 3
South Charleston, WV 25309-1459
Phone
(304) 767-7960
Fax
(304) 767-7969
NPI assigned
Jun 27, 2007
Last updated
May 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Dr. Tara F Ray, D.O.NPI 1033152418
Title
Owner
Phone
(304) 767-7960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 2117 WV Primary

Addresses

Primary practice location

400 Division St
Suite 3
South Charleston, WV 25309-1459

Mailing address

PO Box 9189
South Charleston, WV 25309-0189
Phone (304) 767-7960

Other identifiers 1

IdentifierTypeStateIssuer
3810002665MedicaidWV

National Provider Directory

National Provider Directory

Locations

400 Division St
Ste 3
South Charleston, WV 25309
Phone (304) 766-7860

4607 Maccorkle Ave SW
Ste 305
South Charleston, WV 25309
Phone (304) 767-7820

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1710183504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9189",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253090189",
            "telephone_number": "304-767-7960",
            "fax_number": "304-767-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DIVISION ST",
            "address_2": "SUITE 3",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091459",
            "telephone_number": "304-767-7960",
            "fax_number": "304-767-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TARA F RAY PSYCHIATRIC SERVCIES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-767-7960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "2117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002665",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.