Desiree Raynor, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000019740 Issued in TN

Practice address

818 Sunset Dr Ste 102
Johnson City, TN 37604-8310

Phone

(423) 794-3142

NPI assigned

Jul 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20380/brand/1/csg/1/fhir/r4
• Direct secure messaging: desiree.raynor.1@20380.direct.athenahealth.com

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  TN

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Friends in Need Health Center

  • Primary Care Clinic/Center
  • Kingsport, TN
  • NPI 1871954628
  NPD (past)
• Priority Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
  • NPI 1689816365
  NPD (past)

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1346624095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 SUNSET DR STE 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SUNSET DR STE 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048310",
            "telephone_number": "423-794-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "DESIREE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000019740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q015505",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rawson, PTA
• Ray W. Mettetal Jr., M.D. Inc.
• Alvin Chad Ray, LMFT
• Ethan Matthew Ray
• Janika Ziarah Raynes, MD
• Cheryl A Reardon, DPH, CDE
• Rebirth Advanced Healing LLC
• Paula Reborchick
• Roela Redd
• Julie Marie Reddick, MD

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.