Individual provider Active NPI

Laurie Ann Ray, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1801396361
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2871 Issued in OK
Practice address
1932 NW 23Rd St
Oklahoma City, OK 73106-1202
Phone
(405) 833-1108
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7352 OK
Physician Assistant 363A00000X 2871 OK Primary

Addresses

Primary practice location

1932 NW 23Rd St
Oklahoma City, OK 73106-1202

Mailing address

1932 NW 23Rd St
Oklahoma City, OK 73106-1202
Phone (405) 833-1108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20210709000456 OK Practitioner - Physician Assistant 1052713385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Practice Mental Health, LLCGroup PAC ID 2062814387, 2 clinicians

Practice addresses (Care Compare)

1932 NW 23Rd St
Oklahoma City, OK 73106-1202
Phone (405) 833-1108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2871OKMDProfessional Counselor
7352OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Springs, LLC Past Accepting new patients
Oakwood Springs Physician Group LLC PastSince Mar 28, 2017 Accepting new patients

Organizations & group practices 3

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": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1801396361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 NW 23RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731061202",
            "telephone_number": "405-833-1108",
            "fax_number": "405-673-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 NW 23RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731061202",
            "telephone_number": "405-833-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "7352",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.