Individual provider Active NPI

Cristian Raether

  • Registered Nurse
  • Eagle Butte, SD
National Provider Identifier
1396144010
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R043107 Issued in SD
Practice address
209 South Turtle Drive
Eagle Butte, SD 57625
Phone
(626) 429-1112
NPI assigned
Aug 19, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R043107 SD Primary

Addresses

Primary practice location

209 South Turtle Drive
Eagle Butte, SD 57625

Mailing address

209 South Turtle Drive
Eagle Butte, SD 57625
Phone (626) 429-1112

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
R043107SDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1396144010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SOUTH TURTLE DRIVE",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "626-429-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SOUTH TURTLE DRIVE",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "626-429-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAETHER",
        "first_name": "CRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R043107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Butte, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.