Active NPI
Michael B Raguine, NURSE PRACTITIONER
- Family Nurse Practitioner
- National City, CA
National Provider Identifier
1174867162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 22376
- Practice address
- 2743 Highland Ave
National City, CA 91950-7410 - Phone
- (619) 474-2284
- NPI assigned
- Nov 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 22376 | CA | Primary |
Addresses
Primary practice location
2743 Highland Ave
National City, CA 91950-7410
Mailing address
1233 Morgan Hill Dr
Chula Vista, CA 91913-1435
Phone (619) 565-2549
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22376 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391472000000",
"number": "1174867162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 MORGAN HILL DR",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919131435",
"telephone_number": "619-565-2549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2743 HIGHLAND AVE",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919507410",
"telephone_number": "619-474-2284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAGUINE",
"first_name": "MICHAEL",
"middle_name": "B",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-15",
"last_updated": "2014-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "22376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in National City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.