Active NPI
Larry Dale Ray, M.D.
- Psychiatry Physician
- Reidsville, NC
National Provider Identifier
1831257054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 9800368
- Practice address
- 405 NC 65
Reidsville, NC 27320 - Phone
- (704) 939-1100
- Fax
- (704) 939-1173
- NPI assigned
- Dec 4, 2006
- Last updated
- May 8, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 9800368 | NC | Primary |
Addresses
Primary practice location
405 NC 65
Reidsville, NC 27320
Mailing address
284 Executive Park Dr
Concord, NC 28025-1831
Phone (704) 939-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891058X | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9800368 | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Guilford | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Guilford County Department of Public Health
- State or Local Public Health Clinic/Center
- Greensboro, NC
- NPI 1245272657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494201600000",
"number": "1831257054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251831",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 NC 65",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "27320",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "LARRY",
"middle_name": "DALE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2017-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "9800368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891058X",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reidsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.