Sandra Kay Raby, GNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704138831 Issued in MI

Practice address

100 E Michigan Ave Ste 102
Jackson, MI 49201-1406

Phone

(517) 205-1731

Fax

(517) 205-7649

NPI assigned

Jun 26, 2008

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Nurse Practitioner

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Wa Foote Memorial Hospital, Inc

  • Emergency Medicine Physician
  • Jackson, MI
  • NPI 1265487722
  NPD (past)

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

• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1043472509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011406",
            "telephone_number": "517-205-1731",
            "fax_number": "517-205-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011406",
            "telephone_number": "517-205-1731",
            "fax_number": "517-205-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABY",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "GNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704138831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sraby1@hfhs.org",
            "affiliation": "N",
            "address_1": "100 E Michigan Ave Ste 102",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sraby452981@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "100 E Michigan Ave Ste 102",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda S Quigley, CRNA
• Muhammad Ahmad Qureshi, M.D.
• R C Brillantes M D P L L C
• R Charles Medlar, MD PC
• R M Beredo M D P L L C
• Sara Jeanne Rademacher, DPT
• Jazmyn Ragland
• Rai Care Centers of Michigan I, LLC
• Jana Rajab
• Rajan Pastoriza MD PLC

• Gerontology Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.
• 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.