Marvin Keith Rainwater, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

322314 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-0000

Fax

(318) 629-4833

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, LA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marvin.rainwater.1@3681.direct.athenahealth.com
• Direct secure messaging: mrainwater757412@direct.novanthealth.org

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.

• Minden Physician Practices LLC

  • Multi-Specialty Clinic/Center
  • Minden, LA
  • NPI 1497986764
  Medicare reassignment NPD
• University Health Shreveport LLC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611

  Physician Assistant

  Medicare reassignment NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment
• Webster Emergency Group LLC

  • Emergency Medicine Physician
  • Minden, LA
  • NPI 1245209527
  Medicare reassignment
• Minden Physician Practices LLC

  • Rural Health Clinic/Center
  • Haughton, LA
  • NPI 1699392589
  NPD
• University Health Shreveport LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1629544622
  NPD
• Brfhh Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912909912
  NPD (past)
• Minden Physician Practices LLC

  • Family Nurse Practitioner
  • Minden, LA
  • NPI 1265777957
  NPD (past)
• Orthopaedic Specialists of North Carolina, P.a.

  • Orthopaedic Surgery Physician
  • Raleigh, NC
  • NPI 1649327750
  NPD (past)
• Sterling Emergency Services of the Southeast, Inc

  • Emergency Medicine Physician
  • Salisbury, NC
  • NPI 1770541245

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1457310773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000",
            "fax_number": "318-629-4833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Hanes Square Cir",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271035514",
            "country_code": "US",
            "telephone_number": "336-441-5569",
            "fax_number": "336-771-1907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAINWATER",
        "first_name": "MARVIN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "322314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MRAINWATER757412@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "105 Hanes Square Cir",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271035514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jana S Rains, FNP-C
• Brandon Rainwater
• Carolyn Rainwater, M.A, CCC-SLP
• Howard Allen Rainwater, R.PH.
• Kelly White Rainwater, RPH
• Sara E. Rainwater
• Margaret S Raish, N.P.
• Rajan Khanna MD Apmc
• Rajendra T Gandhi, MD, LLC
• Faryal F Rajput

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.