Active NPI
Jack L Ratliff, MD
- Surgery Physician
- Aiken, SC
National Provider Identifier
1235194515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A35826
- Practice address
- 739 Hayne Ave SW
Aiken, SC 29801-3816 - Phone
- (803) 233-6576
- Fax
- (803) 233-4675
- NPI assigned
- Apr 19, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A35826 | SC | Primary |
Addresses
Primary practice location
739 Hayne Ave SW
Aiken, SC 29801-3816
Mailing address
739 Hayne Ave SW
Aiken, SC 29801-3816
Phone (803) 233-6576
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 083331 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A35826 | SC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1235194515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "739 HAYNE AVE SW",
"city": "AIKEN",
"state": "SC",
"postal_code": "298013816",
"telephone_number": "803-233-6576",
"fax_number": "803-233-4675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "739 HAYNE AVE SW",
"city": "AIKEN",
"state": "SC",
"postal_code": "298013816",
"telephone_number": "803-233-6576",
"fax_number": "803-233-4675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATLIFF",
"first_name": "JACK",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "A35826",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "083331",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.