Organization Active NPI

Raina Imaging Inc

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • St Augustine, FL
National Provider Identifier
1215353172
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
RAINA IMAGING INC
Practice address
245 Land Grant St Unit 6
Saint Augustine, FL 32092-1698
Phone
(904) 992-9749
Fax
(904) 992-8980
NPI assigned
Mar 14, 2014
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Kimberly A Pankey, RVT
Title
Owner
Phone
(904) 992-9749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X NU Primary

Addresses

Primary practice location

245 Land Grant St Unit 6
Saint Augustine, FL 32092-1698

Mailing address

245 Land Grant St Unit 6
Saint Augustine, FL 32092-1698
Phone (904) 992-9749

Medicare participation

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215353172. Details of each certification follow.

Portable X-ray supplier certification: CCN 10X0009971

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RAINA IMAGING, INC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Oct 28, 2011
Last certification
May 30, 2025
Ownership / control type
Corporation
Facility address
245 Land Grant St Unit 6
Saint Augustine, FL 32092

National Provider Directory

National Provider Directory

Locations

3000 Hartley Rd
Ste 1
Jacksonville, FL 32257
Phone (904) 992-9749

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1215353172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 LAND GRANT ST UNIT 6",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921698",
            "telephone_number": "904-992-9749",
            "fax_number": "904-212-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 LAND GRANT ST UNIT 6",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921698",
            "telephone_number": "904-992-9749",
            "fax_number": "904-992-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINA IMAGING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "PANKEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-992-9749",
        "authorized_official_credential": "RVT"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.