Active NPI
Raina Marie Gerritts
- Neurology Physician
- Columbia, MO
National Provider Identifier
1144063199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 2024022822
- Practice address
- 1 Hospital Dr. Ce507 DC 047.0
Columbia, MO 65212 - Phone
- (573) 882-1515
- Fax
- (573) 884-4249
- NPI assigned
- Jun 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 2024022822 | MO | Primary |
Addresses
Primary practice location
1 Hospital Dr. Ce507 DC 047.0
Columbia, MO 65212
Mailing address
1 Hospital Dr. Ce507 DC 047.0
Columbia, MO 65212
Phone (573) 882-1515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240725000814 | MO | Order and Referring Only - Neurology | 3274079363 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024022822 | MO | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1144063199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR. CE507 DC 047.0",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65212",
"telephone_number": "573-882-1515",
"fax_number": "573-884-4249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR. CE507 DC 047.0",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65212",
"telephone_number": "573-882-1515",
"fax_number": "573-884-4249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERRITTS",
"first_name": "RAINA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MO",
"license": "2024022822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.