Active NPI
Michael K Ray, PA-C
- Physician Assistant
- Sheboygan, WI
National Provider Identifier
1962519207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 999-023
- Practice address
- 2414 Kohler Memorial Dr
Sheboygan, WI 53081 - Phone
- (920) 457-4461
- NPI assigned
- Aug 24, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 999-023 | WI | Primary |
Addresses
Primary practice location
2414 Kohler Memorial Dr
Sheboygan, WI 53081
Mailing address
3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 647-6326
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42971100 | Medicaid | WI |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 999-023 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1962519207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 W FOREST HOME AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532152843",
"telephone_number": "414-647-6326",
"fax_number": "414-671-8860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 KOHLER MEMORIAL DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "53081",
"telephone_number": "920-457-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "MICHAEL",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "999-023",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42971100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.