Individual provider Active NPI

Robert Bradley Wray, M.D.

  • Cardiovascular Disease Physician
  • Salt Lake City, UT
National Provider Identifier
1821434424
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
149852-1205 Issued in UT
Practice address
2665 E. Parleys Way
#204
Salt Lake City, UT 84109-1672
Phone
(801) 433-4521
Fax
(801) 433-4521
NPI assigned
May 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 149852-1205 UT
Cardiovascular Disease Physician 207RC0000X 149852-1205 UT Primary

Addresses

Primary practice location

2665 E. Parleys Way
#204
Salt Lake City, UT 84109-1672

Mailing address

2665 E. Parleys Way
#204
Salt Lake City, UT 84109-1672
Phone (801) 433-4521

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
149852-1205UTMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1821434424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 E. PARLEYS WAY",
            "address_2": "#204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091672",
            "telephone_number": "801-433-4521",
            "fax_number": "801-433-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 E. PARLEYS WAY",
            "address_2": "#204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091672",
            "telephone_number": "801-433-4521",
            "fax_number": "801-433-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "ROBERT",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "149852-1205",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "149852-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.