Active NPI
John Raby
- Case Manager/Care Coordinator
- Madison, WV
National Provider Identifier
1073129391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- AP00942085
- Practice address
- 471 Main St Ste B
Madison, WV 25130-1223 - Phone
- (304) 307-6005
- Fax
- (304) 307-6038
- NPI assigned
- Sep 22, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | AP00942085 | WV | Primary |
Addresses
Primary practice location
471 Main St Ste B
Madison, WV 25130-1223
Mailing address
9083 Daniel Boone Pkwy
Foster, WV 25081-6037
Phone (304) 369-0550
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP00942085 | WV | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1073129391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9083 DANIEL BOONE PKWY",
"city": "FOSTER",
"state": "WV",
"postal_code": "250816037",
"telephone_number": "304-369-0550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "471 MAIN ST STE B",
"city": "MADISON",
"state": "WV",
"postal_code": "251301223",
"telephone_number": "304-307-6005",
"fax_number": "304-307-6038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABY",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-22",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "WV",
"license": "AP00942085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.