Organization Active NPI

Raulerson & Raulerson Physicians

  • Specialist
  • Brewton, AL
National Provider Identifier
1073602173
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RAULERSON & RAULERSON PHYSICIANS
Practice address
1205 Belleville Ave
Brewton, AL 36426-1304
Phone
(251) 867-3606
Fax
(251) 867-3610
NPI assigned
Oct 12, 2006
Last updated
Apr 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Authorized official

Name
Dr. James D. Raulerson, M.D.
Title
Ceo/Physician
Phone
(251) 867-3606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

1205 Belleville Ave
Brewton, AL 36426-1304

Mailing address

1205 Belleville Ave.
Brewton, AL 36426
Phone (251) 867-3606

Other identifiers 8

IdentifierTypeStateIssuer
009969685MedicaidAL
51009768OtherALBC/BS OF AL
891003040MedicaidAL
51511894OtherALBC/BS OFAL
51524734OtherALBC/BS OF AL
000009768MedicaidAL
000022662MedicaidAL
51022662OtherALBC/BS AL AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140519002062 AL Part B Supplier - Clinic/Group Practice 8325140676 Receives reassigned benefits from 1 practitioner
Practice locations: Brewton, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1073602173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 BELLEVILLE AVE.",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "36426",
            "telephone_number": "251-867-3606",
            "fax_number": "251-867-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261304",
            "telephone_number": "251-867-3606",
            "fax_number": "251-867-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAULERSON & RAULERSON PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "RAULERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO/PHYSICIAN",
        "authorized_official_telephone_number": "251-867-3606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009969685",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AL",
            "identifier": "51009768",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891003040",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OFAL",
            "identifier": "51511894",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AL",
            "identifier": "51524734",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000009768",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000022662",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS AL AL",
            "identifier": "51022662",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.