Cenean Walls Raphemot, FPMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

17296 Issued in TN

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 423-5174

NPI assigned

Mar 6, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Cenean Grace Fannie Walls Former name

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1104190271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPHEMOT",
        "first_name": "CENEAN",
        "middle_name": "WALLS",
        "name_prefix": "Dr.",
        "credential": "FPMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "184446",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "17296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CENEAN",
            "last_name": "WALLS",
            "middle_name": "GRACE FANNIE",
            "prefix": "MS.",
            "credential": "FPMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gema Argentina Raasch
• Sheela Rajan, M.D.
• Pablo Ramirez
• Dharmesh D Rana, RPH
• Laura Jane Ransom, CRNA
• Jay Rathod, MD
• Stephen Jabari Redmon, MD
• Kevin Reece, D.O.
• Paul H Reed, M.D.
• Shantenesia Leshana Reeves

• Psychiatric/Mental Health Nurse Practitioner in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.