Johnny Valentine Ravenwood

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

5455 Almira Dr NE
Bremerton, WA 98311-8330

Phone

(360) 373-5031

NPI assigned

Feb 4, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GFEJCD/Endpoint/GFEJCD

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.

• Suquamish Tribal

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Suquamish, WA
  • NPI 1083747216
  NPD
• Suquamish Tribal

  • General Practice Physician
  • Suquamish, WA
  • NPI 1114674942

  Case Manager/Care Coordinator

  NPD
• Kitsap Mental Health Services

  • Community/Behavioral Health Agency
  • Bremerton, WA
  • NPI 1033268008
  NPD (past)

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1053903724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118330",
            "telephone_number": "360-373-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118330",
            "telephone_number": "360-373-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVENWOOD",
        "first_name": "JOHNNY",
        "middle_name": "VALENTINE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Rasmussen, PHARM.D.
• Michael Rasmussen
• Saurabh Rastogi, M.D.
• Renee Rastrollo
• Manichanh J. Ratts, PA-C
• Gina Rawson
• Mary Elizabeth Ray, M.D.
• Melissa Rayburn
• Cherise Reaber
• Heather Read

• Case Manager/Care Coordinator in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Case Manager/Care Coordinator in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.