Individual provider Active NPI

Chelsea Ray, CPO

  • Prosthetist
  • Lady Lake, FL
National Provider Identifier
1831684885
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
POR322 Issued in FL
Practice address
761 County Road 466
Lady Lake, FL 32159
Phone
(352) 259-9749
Fax
(352) 259-8209
NPI assigned
Jun 22, 2018
Last updated
Aug 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X POR322 FL
Prosthetist 224P00000X POR322 FL Primary
Mastectomy Fitter 224900000X CFM02896 NU

Addresses

Primary practice location

761 County Road 466
Lady Lake, FL 32159

Mailing address

761 County Road 466
Lady Lake, FL 32159
Phone (352) 259-9749

Other identifiers 2

IdentifierTypeStateIssuer
CPO03691OtherAMERICAN BOARD CERTIFICATION FOR PROSTHETICS & ORTHOTICS
POR322OtherFLFLORIDA DEPARTMENT OF HEALTH

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

State licenses

LicenseStateTypeSpecialty
POR322FLMDOrthotist

Practice roles

OrganizationSpecialtyStatusNew patients
Saunders Prosthetics & Orthotics Group, LLC Orthotist 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.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1831684885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 COUNTY ROAD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-259-9749",
            "fax_number": "352-259-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 COUNTY ROAD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-259-9749",
            "fax_number": "352-259-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "CHELSEA",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "FL",
            "license": "POR322",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "FL",
            "license": "POR322",
            "primary": true
        },
        {
            "code": "224900000X",
            "taxonomy_group": "",
            "desc": "Mastectomy Fitter",
            "state": "NU",
            "license": "CFM02896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD CERTIFICATION FOR PROSTHETICS & ORTHOTICS",
            "identifier": "CPO03691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "POR322",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.