Organization Active NPI

Rapha Family Clinic Inc

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1467847152
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AP124298 Issued in TX
Legal business name
RAPHA FAMILY CLINIC INC
Practice address
9778 Forest LN
Dallas, TX 75243-5702
Phone
(469) 826-9812
Fax
(972) 442-3348
NPI assigned
Mar 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Martina Dike, APNPI 1851728760
Title
Owner
Phone
(469) 826-9812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X AP124298 TX Primary

Addresses

Primary practice location

9778 Forest LN
Dallas, TX 75243-5702

Mailing address

9778 Forest LN
Dallas, TX 75243-5702
Phone (469) 826-9812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019002041 TX Part B Supplier - Clinic/Group Practice 7517276363 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX; Greenville, TX

National Provider Directory

National Provider Directory

Locations

9778 Forest Ln
Dallas, TX 75243
Phone (469) 826-9812

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1467847152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9778 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435702",
            "telephone_number": "469-826-9812",
            "fax_number": "972-442-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9778 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435702",
            "telephone_number": "469-826-9812",
            "fax_number": "972-442-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHA FAMILY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "DIKE",
        "authorized_official_first_name": "MARTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-826-9812",
        "authorized_official_credential": "AP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "AP124298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.