Racc Medical Associates LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RACC MEDICAL ASSOCIATES LLC

Practice address

330 North Wabash Ave
Ste 410
Marion, IN 46952-2677

Phone

(260) 748-3650

Fax

(260) 748-3651

NPI assigned

Dec 9, 2021

Organization subpart

No

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

Authorized official

Name

Daniel Roth, DO

Title

Owner

Phone

(260) 748-3650

Specialties & licenses 2

Addresses

Other identifiers 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Surgery Center of Fort Wayne

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
  • NPI 1780218115

  Member Of

  NPD member

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1013676840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "HUNTERTOWN",
            "state": "IN",
            "postal_code": "467480670",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 NORTH WABASH AVE",
            "address_2": "STE 410",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522677",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACC MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-09",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-748-3650",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300038645",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Qca, Inc
• Quality Care Ambulance, Inc.
• Jennifer K Queen-Russell, LCSW
• Julius O Quezon, P.T,CPED
• Melisa Lee Raber
• Kris Rairdon, OT
• Dhan Raj, MD
• Dharam Raj, MD
• Kavita Raj, DO
• Monika Rajmaira, MD

• Durable Medical Equipment & Medical Supplies in Marion, IN
• Providers in Marion, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.