Ray Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3582 Issued in MN

Legal business name

RAY CHIROPRACTIC PA

Practice address

418 Demers Ave
East Grand Forks, MN 56721-1836

Phone

(218) 773-8403

Fax

(218) 773-9812

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Shanon Robert Ray, DCNPI 1164603833

Title

Ceo

Phone

(218) 773-8403

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanon Robert Ray, D.C

  • Chiropractor
  • East Grand Forks, MN
  • NPI 1164603833
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1811076086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211836",
            "telephone_number": "218-773-8403",
            "fax_number": "218-773-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211836",
            "telephone_number": "218-773-8403",
            "fax_number": "218-773-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAY CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "SHANON",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-773-8403",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIRO CARE",
            "identifier": "89332",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "71D82RA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Kay Purcell, DPT
• Angelina Pylka, MS, LPCC
• Mayuresh Rajaratnam, MD
• Tiffany Ramirez
• Adaire Ranstrom, MT-BC
• Shanon Robert Ray, D.C
• Red River Dental Clinic LTD
• Red River Plastic Surgery Center
• Jerald W Reinhardt, MD
• Andrew Reiter

• Chiropractor in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.