Individual provider Active NPI

Raymond Randall Alferink, D.P.M.

  • Podiatrist
  • Fairview Park, OH
National Provider Identifier
1053463117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1686 Issued in OH
Practice address
4492 W 220TH St
Fairview Park, OH 44126-3340
Phone
(440) 734-2228
Fax
(440) 734-1793
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

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
Podiatrist 213E00000X 1686 OH Primary

Addresses

Primary practice location

4492 W 220TH St
Fairview Park, OH 44126-3340

Mailing address

4492 W 220TH St
Fairview Park, OH 44126-3340
Phone (440) 734-2228

Other identifiers 1

IdentifierTypeStateIssuer
0487727MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
1686OHMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053463117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4492 W 220TH ST",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263340",
            "telephone_number": "440-734-2228",
            "fax_number": "440-734-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4492 W 220TH ST",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263340",
            "telephone_number": "440-734-2228",
            "fax_number": "440-734-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFERINK",
        "first_name": "RAYMOND",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "1686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487727",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.