Kevin Kyle Raymer, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

44721 Issued in AZ

Practice address

126 E Main St Ste B
Payson, AZ 85541-5488

Phone

(928) 472-4675

Fax

(928) 472-3431

NPI assigned

May 1, 2007

Last updated

Oct 5, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Payson Healthcare Management Inc

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1093718694
  NPD (past)
• Emergency Services of Kansas, PA

  • Internal Medicine Physician
  • Newton, KS
  • NPI 1104864503

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1164643789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 859",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855470859",
            "telephone_number": "928-472-4675",
            "fax_number": "928-472-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415488",
            "telephone_number": "928-472-4675",
            "fax_number": "928-472-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMER",
        "first_name": "KEVIN",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-32629",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "44721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200573240A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623101",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "110171004",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "110150004",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter Frederick Raddatz, PHARMACIST
• Raley's Arizona LLC (Bashas)
• Kelsey Nicole Randall, RDMS
• Anna Ransom
• Katharine Ann Raymer, MD
• Regency Medical Equipment Inc (Rotech)
• Regenthetics, LLC
• Shaylee Renner, DO
• Christopher Ugochukwu Ugorji Rex, M.D.
• Tamara Rike

• Family Medicine Physician in Payson, AZ
• Providers in Payson, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.