Individual provider Active NPI

Kimbrelee Kaye Ray, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooksville, FL
National Provider Identifier
1730828625
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11019969 Issued in FL
Practice address
15311 Cortez Blvd
Brooksville, FL 34613-6005
Phone
(352) 540-9335
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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 11019969 FL Primary

Addresses

Primary practice location

15311 Cortez Blvd
Brooksville, FL 34613-6005

Mailing address

15311 Cortez Blvd
Brooksville, FL 34613-6005
Phone (352) 540-9335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220628003062 FL Practitioner - Nurse Practitioner 2961881552 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11019969FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Management Services Inc CurrentSince Jun 24, 2022 Accepting new patients
Baycare Behavioral Health Associates LLC CurrentSince Jun 24, 2022 Accepting new patients
Winter Haven Hospital Inc CurrentSince Jun 24, 2022 Accepting new patients
Behavioral Health Management Services, Inc. Current Accepting new patients
Baycare Behavioral Health, Inc CurrentSince Jun 24, 2022 Accepting new patients
Baycare Behavioral Health Associates LLC CurrentSince Jun 24, 2022 Accepting new patients
Baycare Behavioral Health Inc. Current Accepting new patients
Baycare Behavioral Health, Inc CurrentSince Jun 24, 2022 Accepting new patients
Winter Haven Hospital Inc CurrentSince Jun 24, 2022 Accepting new patients
Behavioral Health Management Services, Inc. CurrentSince Jun 24, 2022 Accepting new patients

Locations

15311 Cortez Blvd
Brooksville, FL 34613
Phone (352) 467-6529

1106 Druid Rd S
Clearwater, FL 33756
Phone (727) 584-6266

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

7809 Massachusetts Ave
Ste 100
New Prt Rchy, FL 34653
Phone (727) 841-4200

6600 Madison St
New Pt Richey, FL 34652
Phone (727) 841-4611

2727 W Mlk Blvd
Ste 640
Tampa, FL 33607
Phone (813) 842-7582

Organizations & group practices 10

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1730828625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15311 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346136005",
            "telephone_number": "352-540-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15311 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346136005",
            "telephone_number": "352-540-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "KIMBRELEE",
        "middle_name": "KAYE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11019969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.