Misty Lee Wray MD LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D0040969 Issued in MD

Legal business name

MISTY LEE WRAY MD LLC

Practice address

900 Bestgate Rd
Suite 104
Annapolis, MD 21401-3089

Phone

(443) 221-7775

NPI assigned

Jul 31, 2013

Organization subpart

No

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

Authorized official

Name

Misty Lee Wray, MD

Title

Owner

Phone

(443) 221-7775

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1851723977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BESTGATE RD",
            "address_2": "SUITE 104",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013089",
            "telephone_number": "443-221-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BESTGATE RD",
            "address_2": "SUITE 104",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013089",
            "telephone_number": "443-221-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISTY LEE WRAY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "WRAY",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-221-7775",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0040969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "D0040969",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Annapolis, MD
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• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.