Active NPI
Dave M. Rayburn, M.D.
- Surgery Physician
- Pineville, LA
National Provider Identifier
1154412856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 16870
- Practice address
- 390 Griffith St.
Pineville, LA 71360 - Phone
- (318) 443-6323
- Fax
- (318) 443-6189
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 16870 | LA | Primary |
Addresses
Primary practice location
390 Griffith St.
Pineville, LA 71360
Mailing address
390 Griffith Street
Pineville, LA 71360
Phone (318) 443-6323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1353787 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- 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 |
|---|---|---|---|---|
| I20120411000137 | LA | Practitioner - General Surgery | 0547421091 | Practice locations: Pineville, LA |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
390 Griffith St
Pineville, LA 71360-5271
Phone (318) 443-6323
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16870 | LA | MD | Surgery Physician |
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Alexandria, LA
- NPI 1477500015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228867200000",
"number": "1154412856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 GRIFFITH STREET",
"city": "PINEVILLE",
"state": "LA",
"postal_code": "71360",
"telephone_number": "318-443-6323",
"fax_number": "318-443-6189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 GRIFFITH ST.",
"city": "PINEVILLE",
"state": "LA",
"postal_code": "71360",
"telephone_number": "318-443-6323",
"fax_number": "318-443-6189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYBURN",
"first_name": "DAVE",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2008-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "LA",
"license": "16870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1353787",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pineville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.