Ryan Matthew Raborn, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501014355 Issued in MI

Practice address

13060 S US Highway 27 Ste C4
Dewitt, MI 48820-8619

Phone

(517) 668-6561

Fax

(517) 306-2372

NPI assigned

Mar 13, 2009

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jdr74 Holdings, LLCGroup PAC ID 8325302748, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Jdr74 Holdings, LLC

  • Physical Therapist
  • Dewitt, MI
  • NPI 1649779331
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562198400000",
    "number": "1477794881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13060 S US HIGHWAY 27 STE C4",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208619",
            "telephone_number": "517-668-6561",
            "fax_number": "517-306-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13060 S US HIGHWAY 27 STE C4",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208619",
            "telephone_number": "517-668-6561",
            "fax_number": "517-306-2372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1375 S Lapeer Rd",
            "address_2": "ste 209",
            "address_purpose": "LOCATION",
            "city": "Lake Orion",
            "state": "MI",
            "postal_code": "483601421",
            "country_code": "US",
            "telephone_number": "248-814-0500",
            "fax_number": "248-814-0509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RABORN",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2019-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara B Peters, R.PH.
• Robin Phillips, PT
• Aryn Pierce, SLP
• Melissa Potter
• Practical Rehabilitation Services, LLC
• Baraa Rad
• Stephanie M Radawiec, PT
• Muhammad Salman Rais
• Bruce Miller Reinoehl, M.D.
• Samantha Marie Rice

• Physical Therapist in Dewitt, MI
• Providers in Dewitt, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.