Individual provider Active NPI

Raines Atherton Chaffin, MD

  • Family Medicine Physician
  • Tupelo, MS
National Provider Identifier
1083898803
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N-8132 Issued in AR
Practice address
125 County Road 1698
Tupelo, MS 33804
Phone
(501) 454-1960
NPI assigned
Dec 28, 2007
Last updated
Dec 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N-8132 AR Primary

Addresses

Primary practice location

125 County Road 1698
Tupelo, MS 33804

Mailing address

125 County Road 1698
Tupelo, MS 33804
Phone (501) 454-1960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090120000724 AR Practitioner - Family Practice 5395798870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medcare, Inc CurrentSince Nov 10, 2008 Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1083898803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COUNTY ROAD 1698",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "33804",
            "telephone_number": "501-454-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COUNTY ROAD 1698",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "33804",
            "telephone_number": "501-454-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFIN",
        "first_name": "RAINES",
        "middle_name": "ATHERTON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N-8132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.