Individual provider Active NPI

Jimmie Rhea Crain, RRT

  • Registered Respiratory Therapist
  • Tallahassee, FL
National Provider Identifier
1306196126
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
6684 Issued in FL
Practice address
3492 Martin Hurst Rd
Tallahassee, FL 32312-1702
Phone
(850) 701-3920
Fax
(850) 701-3924
NPI assigned
Sep 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 6684 FL Primary

Addresses

Primary practice location

3492 Martin Hurst Rd
Tallahassee, FL 32312-1702

Mailing address

3200 N Shannon Lakes Dr
Tallahassee, FL 32309-2312
Phone (850) 688-3243

Other identifiers 1

IdentifierTypeStateIssuer
006606400MedicaidFL

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

LicenseStateTypeSpecialty
6684FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatria Healthcare, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1306196126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N SHANNON LAKES DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092312",
            "telephone_number": "850-688-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3492 MARTIN HURST RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121702",
            "telephone_number": "850-701-3920",
            "fax_number": "850-701-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIN",
        "first_name": "JIMMIE",
        "middle_name": "RHEA",
        "name_prefix": "Mr.",
        "credential": "RRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-19",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "FL",
            "license": "6684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006606400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.