Organization Active NPI

Sheila M. Ray MD PC

  • Specialist
  • Southgate, MI
National Provider Identifier
1790009868
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
051263 Issued in MI
Legal business name
SHEILA M. RAY MD PC
Practice address
13136 Fort St.
Southgate, MI 48195
Phone
(734) 284-7223
Fax
(734) 284-9580
NPI assigned
Mar 18, 2010
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Dr. Sheila M Ray, MDNPI 1982826707
Title
Doctor
Phone
(734) 284-7223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 051263 MI Primary

Addresses

Primary practice location

13136 Fort St.
Southgate, MI 48195

Mailing address

13136 Fort St
Southgate, MI 48195-1102
Phone (734) 284-7223

Other identifiers 1

IdentifierTypeStateIssuer
289162510MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130320000506 MI Part B Supplier - Clinic/Group Practice 5597900605 Receives reassigned benefits from 2 practitioners
Practice locations: Southgate, MI

National Provider Directory

National Provider Directory

Locations

13136 Fort St
Southgate, MI 48195
Phone (734) 284-7223

Practitioners & affiliated clinicians

Practitioners 3

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": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1790009868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13136 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951102",
            "telephone_number": "734-284-7223",
            "fax_number": "734-284-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13136 FORT ST.",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "48195",
            "telephone_number": "734-284-7223",
            "fax_number": "734-284-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEILA M. RAY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "734-284-7223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "051263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289162510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.