Brianna Leigh Raab, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5601010336 Issued in MI

Practice address

610 Taylor St
Delta, OH 43515-1046

Phone

(419) 277-2837

NPI assigned

Dec 15, 2020

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 7, 2021 through Sep 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hope419, LLC

  dba Hope419

  • Psychiatry Physician
  • Ontario, OH
  • NPI 1184375628

  Family Medicine

  NPD (past)
• Hope419, LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Ontario, OH
  • NPI 1750990438

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1164018008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 COLUMBIA AVE E",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 TAYLOR ST",
            "city": "DELTA",
            "state": "OH",
            "postal_code": "435151046",
            "telephone_number": "419-277-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAB",
        "first_name": "BRIANNA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5601010336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Munger, RN. BSN.
• Dexter L Phillips Jr., D.O.
• Melanie Jane Pickard, LPN
• Pike-Delta-York Local School District
• Tiffany Ann Pollauf
• Lynlee Reinking
• Roxanne Miller
• Kathleen Marie Savage, LPN
• Kaleena Schlosser
• Annette Shotwell

• Family Medicine Physician in Delta, OH
• Providers in Delta, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.