Individual provider Active NPI

Lisa Rainey, M.D.

  • Pediatrics Physician
  • Alexandria, VA
National Provider Identifier
1174544399
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101222832 Issued in VA
Practice address
205 S Whiting St Ste 205
Alexandria, VA 22304-3632
Phone
(703) 823-7400
Fax
(703) 823-5814
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0055310 MD
Pediatrics Physician 208000000X 0101222832 VA Primary

Addresses

Primary practice location

205 S Whiting St Ste 205
Alexandria, VA 22304-3632

Mailing address

205 S Whiting St Ste 200
Alexandria, VA 22304-3693
Phone (703) 823-7400

Other practice location 1

9520 Philadelphia Rd
Rosedale, MD 21237-4106
Phone (410) 558-4700

Other identifiers 2

IdentifierTypeStateIssuer
217436OtherVAANTHEM PROVIDER NUMBER
006705111MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240730003897 MD Practitioner - Pediatric Medicine 7911444609 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0055310MDMDPediatrics Physician
0101222832VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Medical System, Inc. CurrentSince Jun 13, 2024 Accepting new patients
Baltimore Medical System, Inc. CurrentSince Jun 13, 2024 Accepting new patients

Locations

1000 Stewart Ave
Glen Burnie, MD 21061

9520 Philadelphia Rd
Rosedale, MD 21237
Phone (410) 558-4700

Interoperability endpoints

  • Direct secure messaging: lisa.rainey@wep.eclinicaldirectplus.com
  • Direct secure messaging: lisa.rainey.p1@direct.bmsi.nextgenshare.com

Organizations & group practices 2

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1174544399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S WHITING ST STE 200",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223043693",
            "telephone_number": "703-823-7400",
            "fax_number": "703-823-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S WHITING ST STE 205",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223043632",
            "telephone_number": "703-823-7400",
            "fax_number": "703-823-5814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9520 Philadelphia Rd",
            "address_purpose": "LOCATION",
            "city": "Rosedale",
            "state": "MD",
            "postal_code": "212374106",
            "country_code": "US",
            "telephone_number": "410-558-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0055310",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101222832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "217436",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006705111",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.