NPIMap

Individual provider Active NPI

Justin S Bray, O.T

  • Occupational Therapist
  • London, KY
National Provider Identifier
1760870927
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
R5014 Issued in KY
Practice address
100 London Mountain View Dr
Suite 400
London, KY 40741-6601
Phone
(606) 330-0513
Fax
(606) 330-0516
NPI assigned
Dec 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X R5014 KY Primary

Addresses

Primary practice location

100 London Mountain View Dr
Suite 400
London, KY 40741-6601

Mailing address

PO Box 241686
Montgomery, AL 36124-1686
Phone (334) 396-3273

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

State licenses

LicenseStateTypeSpecialty
R5014KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Solutions Holdings, LLC PastSince Jul 23, 2014 Accepting new patients
Saint Joseph Health System, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1760870927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241686",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361241686",
            "telephone_number": "334-396-3273",
            "fax_number": "334-396-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LONDON MOUNTAIN VIEW DR",
            "address_2": "SUITE 400",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416601",
            "telephone_number": "606-330-0513",
            "fax_number": "606-330-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "JUSTIN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "O.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R5014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.