Individual provider Active NPI

Andra Leigh Ray, ARNP, PMHNP-BC, LPC

  • Psychiatric/Mental Health Nurse Practitioner
  • Graham, TX
National Provider Identifier
1790725323
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1140635 Issued in TX
Practice address
617 3Rd St
Graham, TX 76450-3101
Phone
(940) 549-2259
Fax
(940) 549-2886
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 1140635 TX Primary
Professional Counselor 101YP2500X 13713 TX

Addresses

Primary practice location

617 3Rd St
Graham, TX 76450-3101

Mailing address

617 3Rd St
Graham, TX 76450-3101
Phone (940) 549-2259

Other identifiers 1

IdentifierTypeStateIssuer
027311203MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240108003827 TX Practitioner - Nurse Practitioner 4385095033 Practice locations: Graham, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

617 3Rd St
Graham, TX 76450-3101
Phone (940) 549-2259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13713TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Andra Ray Professional CurrentSince Dec 20, 1996 Accepting new patients
Ray and Ray Counseling Services Professional CurrentSince Dec 20, 1996 Accepting new patients

Locations

617 3rd St
Graham, TX 76450
Phone (940) 549-2259

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1790725323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 3RD ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503101",
            "telephone_number": "940-549-2259",
            "fax_number": "940-549-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 3RD ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503101",
            "telephone_number": "940-549-2259",
            "fax_number": "940-549-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ANDRA",
        "middle_name": "LEIGH",
        "credential": "ARNP, PMHNP-BC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1140635",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13713",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027311203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Graham, TX

Sources for this page

Verify at the official NPI Registry.