Active NPI
Candace Smith Raybon, OT
- Occupational Therapist
- Forest, MS
National Provider Identifier
1295098135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT2450
- Practice address
- 1129 Hwy 35 S
Ste 2
Forest, MS 39232 - Phone
- (601) 469-1001
- Fax
- (601) 469-1009
- NPI assigned
- Jun 15, 2012
- Last updated
- Jun 15, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT2450 | MS | Primary |
Addresses
Primary practice location
1129 Hwy 35 S
Ste 2
Forest, MS 39232
Mailing address
2015 Highpointe Drive
Brandon, MS 39042
Phone (601) 824-8814
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT2450 | MS | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medicomp, Inc | Past | Accepting new patients | |
| Medicomp, Inc | Past | Accepting new patients | |
| Medicomp, Inc | Past | Accepting new patients |
Organizations & group practices 3
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": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1295098135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 HIGHPOINTE DRIVE",
"city": "BRANDON",
"state": "MS",
"postal_code": "39042",
"telephone_number": "601-824-8814",
"fax_number": "601-824-8816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 HWY 35 S",
"address_2": "STE 2",
"city": "FOREST",
"state": "MS",
"postal_code": "39232",
"telephone_number": "601-469-1001",
"fax_number": "601-469-1009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYBON",
"first_name": "CANDACE",
"middle_name": "SMITH",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-15",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "OT2450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest, MS
- Ashley Powell, FNP-C
- Premise Health of Mississippi Medical PC (Unipres - Forest)
- Haley Huey Purvis, SLP
- Quick Quality Care Or Mississippi, Llcdba Checkups (CheckUps)
- R. D. Eason OD PA
- Region Ten Commission on Mental Health (Weems Mental Health)
- Ethan Reiss
- Reynolds Dental Practice
- Kevin M Reynolds, D.M.D
- Randy K Reynolds, D.M.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.