Individual provider Active NPI

William M Raich, NCTMB

  • Specialist
  • Anoka, MN
National Provider Identifier
1174714497
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
209 Clay Street
Apt#9
Anoka, MN 55303
Phone
(612) 239-8265
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

209 Clay Street
Apt#9
Anoka, MN 55303

Mailing address

209 Clay St
Apt#9
Anoka, MN 55303-6779
Phone (612) 239-8265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1174714497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CLAY ST",
            "address_2": "APT#9",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553036779",
            "telephone_number": "612-239-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CLAY STREET",
            "address_2": "APT#9",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "55303",
            "telephone_number": "612-239-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAICH",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "NCTMB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.