Active NPI
Randal J Rabon, M.D.
- Ophthalmology Physician
- Johnson City, TN
National Provider Identifier
1487612453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD17603
- Practice address
- 110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004 - Phone
- (423) 929-2111
- Fax
- (423) 929-0497
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD17603 | TN | Primary |
Addresses
Primary practice location
110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Mailing address
110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone (423) 929-2111
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180036693 | Other | TN | PALMETTO RAILROAD MEDICAR |
| 180043453 | Other | VA | PALMETTO RAILROAD MEDICAR |
| 3023756 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17603 | TN | MD | Ophthalmology Physician |
Organizations & group practices 1
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.
-
- Ophthalmology Physician
- Johnson City, TN
- NPI 1700827961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261526400000",
"number": "1487612453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MED TECH PKWY",
"address_2": "SUITE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044004",
"telephone_number": "423-929-2111",
"fax_number": "423-929-0497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MED TECH PKWY",
"address_2": "SUITE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044004",
"telephone_number": "423-929-2111",
"fax_number": "423-929-0497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABON",
"first_name": "RANDAL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2009-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TN",
"license": "MD17603",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RAILROAD MEDICAR",
"identifier": "180036693",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RAILROAD MEDICAR",
"identifier": "180043453",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3023756",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.