Individual provider Active NPI

Garth E Wray, CRNA

  • Certified Registered Nurse Anesthetist
  • Grand Forks, ND
National Provider Identifier
1992891253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R25468 Issued in ND
Practice address
1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone
(701) 780-5000
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R25468 ND Primary

Addresses

Primary practice location

1200 S Columbia Rd
Grand Forks, ND 58201-4036

Mailing address

PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041228000728 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042278749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

4500 S Washington St
Suite B
Grand Forks, ND 58201-7217
Phone (701) 732-7400

Hospital & facility affiliations

  • Altru Hospital Hospital, Grand Forks, ND, CCN 350019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Sep 7, 2004 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Sep 7, 2004 Accepting new patients

Locations

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1000 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5089

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992891253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6002",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582066002",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014036",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "GARTH",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R25468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.