Individual provider Active NPI

Rachel Morales Ricafort, MD

  • Pediatrics Physician
  • Smyrna, TN
National Provider Identifier
1083609689
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD34715 Issued in TN
Practice address
739 President PL Ste 110
Smyrna, TN 37167-6845
Phone
(615) 625-7780
Fax
(615) 625-7781
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD34715 TN Primary

Addresses

Primary practice location

739 President PL Ste 110
Smyrna, TN 37167-6845

Mailing address

739 President PL Ste 110
Smyrna, TN 37167-6845
Phone (615) 625-7780

Other identifiers 1

IdentifierTypeStateIssuer
5440520MedicaidTN

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD34715TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Pediatrics PC Pediatrics PastSince Oct 1, 2012 Accepting new patients
Smyrna Pediatrics PLLC Pediatrics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083609689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 PRESIDENT PL STE 110",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676845",
            "telephone_number": "615-625-7780",
            "fax_number": "615-625-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 PRESIDENT PL STE 110",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676845",
            "telephone_number": "615-625-7780",
            "fax_number": "615-625-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICAFORT",
        "first_name": "RACHEL",
        "middle_name": "MORALES",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD34715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440520",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.