Kirstin Louise Bray, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95018088 Issued in CA

Practice address

3109 Coffee Rd Ste a
Modesto, CA 95355-1766

Phone

(209) 522-0001

NPI assigned

Aug 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• 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

Interoperability endpoints

• Direct secure messaging: kirstin.bray.1@29786.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1952327256
  NPD

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1972278653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 COFFEE RD STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551766",
            "telephone_number": "209-522-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 COFFEE RD STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551766",
            "telephone_number": "209-522-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1429 College Ave Ste K",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953504046",
            "country_code": "US",
            "telephone_number": "209-521-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAY",
        "first_name": "KIRSTIN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reception@modestopediatrics.com",
            "affiliation": "N",
            "address_1": "3109 Coffee Rd Ste A",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953551766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jocelynn Bravo
• Perla Bravo
• Erika Bray Ortega, O.D.
• Delaney Bray
• Jaelynn Bray
• Jeffrey L Brayshaw, PA
• Nicole Therese Brazell, LPT
• Sarah Breakey
• Breakthroughs Outpatient Treatment
• Ashley Marie Brechtfeldt

• Family Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.