Individual provider Active NPI

John Rainey, CPED

  • Pedorthist
  • Raleigh, NC
National Provider Identifier
1114689155
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PedorthistTaxonomy code 224L00000X
License
CPED4184 Issued in VA
Practice address
3100 Duraleigh Rd Ste 207
Raleigh, NC 27612-8106
Phone
(984) 200-7950
Fax
(984) 200-8370
NPI assigned
Oct 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X NC
Pedorthist 224L00000X CPED4184 VA Primary
Orthotic Fitter 225000000X CFO04357 VA

Addresses

Primary practice location

3100 Duraleigh Rd Ste 207
Raleigh, NC 27612-8106

Mailing address

3100 Duraleigh Rd Ste 207
Raleigh, NC 27612-8106
Phone (984) 200-7950

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

LicenseStateTypeSpecialty
CPED4184VAMDPedorthist
CFO04357VAMDOrthotic Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Shivag Diabetic Shoes and Orthotics LLC CurrentSince Oct 10, 2021 Accepting new patients

Locations

3100 Duraleigh Rd
Ste 207
Raleigh, NC 27612
Phone (984) 200-7950

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1114689155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 DURALEIGH RD STE 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128106",
            "telephone_number": "984-200-7950",
            "fax_number": "984-200-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 DURALEIGH RD STE 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128106",
            "telephone_number": "984-200-7950",
            "fax_number": "984-200-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "JOHN",
        "credential": "CPED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "VA",
            "license": "CPED4184",
            "primary": true
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "VA",
            "license": "CFO04357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.