Individual provider Active NPI

Marie Raime, M.D

  • Family Medicine Physician
  • Lake City, FL
National Provider Identifier
1407884018
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME85010 Issued in FL
Practice address
1283 SW State Road 47
Suite 103
Lake City, FL 32025-0489
Phone
(386) 754-0339
Fax
(306) 754-0393
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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 ME85010 FL Primary

Addresses

Primary practice location

1283 SW State Road 47
Suite 103
Lake City, FL 32025-0489

Mailing address

PO Box 3412
Lake City, FL 32056-3412
Phone (386) 754-0339

Other identifiers 1

IdentifierTypeStateIssuer
009896400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041227000029 FL Practitioner - Emergency MedicinePractitioner - Family Practice 7416915350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME85010FLMDFamily Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCHCBA/Endpoint/GCHCBA

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1407884018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3412",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320563412",
            "telephone_number": "386-754-0339",
            "fax_number": "386-754-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 SW STATE ROAD 47",
            "address_2": "SUITE 103",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250489",
            "telephone_number": "386-754-0339",
            "fax_number": "306-754-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIME",
        "first_name": "MARIE",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME85010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009896400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.