NPIMap

Individual provider Active NPI

John Clyde Rickabaugh, MD

  • Family Medicine Physician
  • Morehead City, NC
National Provider Identifier
1396722534
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9400133 Issued in NC
Practice address
3608 Medical Park CT
Morehead City, NC 28557-4347
Phone
(252) 247-3476
Fax
(252) 247-3478
NPI assigned
Dec 29, 2005
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9400133 NC Primary

Addresses

Primary practice location

3608 Medical Park CT
Morehead City, NC 28557-4347

Mailing address

3608 Medical Park CT
Morehead City, NC 28557-4347
Phone (252) 247-3476

Other identifiers 1

IdentifierTypeStateIssuer
8971397MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000686 NC Practitioner - Family Practice 8820900285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sound Medical PAGroup PAC ID 4880757970, 5 clinicians

Practice addresses (Care Compare)

3608 Medical Park CT
Morehead City, NC 28557-4347
Phone (252) 247-3476

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions62
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Medical, P.a. Family Medicine CurrentSince Jan 12, 2009 Accepting new patients
Sound Medical, P.a. Family Medicine CurrentSince Jan 12, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Open Water Medical, PA Family Medicine Past Accepting new patients
Seaside Family Practice of Beaufort, Inc. Past Accepting new patients

Locations

300E Taylor Notion Rd
Cape Carteret, NC 28584
Phone (252) 354-1970

3608 Medical Park Ct
Morehead City, NC 28557
Phone (252) 247-3476

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1396722534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 MEDICAL PARK CT",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574347",
            "telephone_number": "252-247-3476",
            "fax_number": "252-247-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 MEDICAL PARK CT",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574347",
            "telephone_number": "252-247-3476",
            "fax_number": "252-247-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKABAUGH",
        "first_name": "JOHN",
        "middle_name": "CLYDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9400133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8971397",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.