Organization Active NPI

Charles E. Ray, M.D. Apmc

  • Internal Medicine Physician
  • Jennings, LA
National Provider Identifier
1750607412
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHARLES E. RAY, M.D. APMC
Practice address
1910 Johnson St
Jennings, LA 70546-3628
Phone
(337) 824-9012
Fax
(337) 824-9018
NPI assigned
Apr 20, 2010
Last updated
Apr 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name
Charles E Ray, M.D. Apmc, MD
Title
Physician
Phone
(337) 824-9012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1910 Johnson St
Jennings, LA 70546-3628

Mailing address

PO Box 1427
Jennings, LA 70546-1427
Phone (337) 824-9012

Other identifiers 2

IdentifierTypeStateIssuer
4388804890OtherLABLUE CROSS OF LA
1346110MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100423000387 LA Part B Supplier - Clinic/Group Practice 5597737486 Receives reassigned benefits from 1 practitioner
Practice locations: Jennings, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2327240Charles E Ray, MD, Apmc1910 Johnson Street, Jennings, LA 70546Certificate of waiverJul 17, 2027

National Provider Directory

National Provider Directory

Locations

1910 Johnson St
Jennings, LA 70546
Phone (337) 824-9012

Practitioners & affiliated clinicians

Practitioners 2

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": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1750607412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1427",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705461427",
            "telephone_number": "337-824-9012",
            "fax_number": "337-824-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 JOHNSON ST",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463628",
            "telephone_number": "337-824-9012",
            "fax_number": "337-824-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E. RAY, M.D. APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "RAY, M.D. APMC",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "337-824-9012",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF LA",
            "identifier": "4388804890",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346110",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.