Individual provider Active NPI

Robert D Carraway, MD

  • Internal Medicine Physician
  • Sumterville, FL
National Provider Identifier
1245317635
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME18201 Issued in FL
Practice address
1389 S US Hwy 301
Sumterville, FL 33585-5135
Phone
(352) 793-5900
Fax
(352) 793-9558
NPI assigned
Nov 1, 2006
Last updated
Nov 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME18201 FL Primary

Addresses

Primary practice location

1389 S US Hwy 301
Sumterville, FL 33585-5135

Mailing address

1425 S US Hwy 301
Sumterville, FL 33585-5135
Phone (352) 793-5900

Other identifiers 2

IdentifierTypeStateIssuer
44102OtherFLBLUE CROSS BLUE SHIELD
276934400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070220000121 FL Practitioner - Internal Medicine 5698877868 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18201FLMDOccupational Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: robert.carraway.1@26900.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1245317635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S US HWY 301",
            "city": "SUMTERVILLE",
            "state": "FL",
            "postal_code": "335855135",
            "telephone_number": "352-793-5900",
            "fax_number": "352-793-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 S US HWY 301",
            "city": "SUMTERVILLE",
            "state": "FL",
            "postal_code": "335855135",
            "telephone_number": "352-793-5900",
            "fax_number": "352-793-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAWAY",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME18201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "44102",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276934400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumterville, FL

Sources for this page

Verify at the official NPI Registry.