NPIMap

Individual provider Active NPI

Brenda S Bray, PA

  • Physician Assistant
  • Harrisville, MI
National Provider Identifier
1992748750
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003785 Issued in MI
Practice address
205 N State St Ste a
Harrisville, MI 48740-9255
Phone
(989) 724-5655
Fax
(989) 358-3730
NPI assigned
Jun 13, 2006
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003785 MI Primary

Addresses

Primary practice location

205 N State St Ste a
Harrisville, MI 48740-9255

Mailing address

PO Box 655
Alpena, MI 49707-0655
Phone (989) 736-9815

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

LicenseStateTypeSpecialty
5601003785MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alcona Citizens for Health, Inc. Physician Assistant Current Accepting new patients
Indigo Hospital Medicine - Iron Mountain PLC Past Accepting new patients
Advanced Cardiac Healthcare, PLC Past Accepting new patients
Indigo Hospital Medicine - Alpena, PLC Past Accepting new patients
Indigo Hospital Medicine - Ludington, PLC Past Accepting new patients
Northern Michigan Emergenc Physicians, LLP Physician Assistant Past Accepting new patients

Locations

177 N Barlow Rd
Harrisville, MI 48740
Phone (989) 736-3020

Organizations & group practices 6

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1992748750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 655",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497070655",
            "telephone_number": "989-736-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N STATE ST STE A",
            "city": "HARRISVILLE",
            "state": "MI",
            "postal_code": "487409255",
            "telephone_number": "989-724-5655",
            "fax_number": "989-358-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "BRENDA",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.