Ellen Ray

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2023033858 Issued in MO

Practice address

4525 Mid Rivers Mall Dr Ste 10
Cottleville, MO 63376-2820

Phone

(636) 229-3350

NPI assigned

Jul 27, 2023

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment NPD
• Mercy Clinic ENT LLC

  • Otolaryngology Physician
  • Washington, MO
  • NPI 1366705998
  Medicare reassignment NPD
• Mercy Clinic East Communities

  • Multi-Specialty Clinic/Center
  • Wildwood, MO
  • NPI 1164857397
  NPD
• Sound Health Services P.C.

  • Otolaryngology Physician
  • Saint Louis, MO
  • NPI 1811988611
  NPD (past)

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1932880333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776442",
            "telephone_number": "636-229-3350",
            "fax_number": "636-229-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 MID RIVERS MALL DR STE 10",
            "city": "COTTLEVILLE",
            "state": "MO",
            "postal_code": "633762820",
            "telephone_number": "636-229-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2023033858",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MO",
            "license": "2005005840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Mitchell, D.O.
• Margaret M. Mueller, M.D.
• Neelima Nalluri
• Katherine Ellen Pavia, APRN-C
• Lindsey Powell, RBT
• Joseph Kenneth Reid, DMD
• David Sanford II
• Joshua Daniel Schnurbusch, RBT
• Katherine M. Shiue, M.D.
• Mariela Showalter

• Pediatric Nurse Practitioner in Cottleville, MO
• Providers in Cottleville, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.