Individual provider Active NPI

Nathan Philip Rainwater

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1497271175
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402312 Issued in NY
Practice address
115 Broadway Ste 1800
New York, NY 10006
Phone
(212) 858-9199
Fax
(212) 858-9148
NPI assigned
Aug 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 173978 TN
General Practice Registered Nurse 163WG0000X 736219 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402312 NY Primary

Addresses

Primary practice location

115 Broadway Ste 1800
New York, NY 10006

Mailing address

115 Broadway Ste 1800
New York, NY 10006-1652
Phone (212) 858-9199

Other practice location 1

110 Lafayette St Fl 5
New York, NY 10013-4116
Phone (212) 369-6757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251001003215 NY Order and Referring Only - Nurse Practitioner 4587160262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
736219NYMDGeneral Practice Registered Nurse
173978TNMDGeneral Practice Registered Nurse

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1497271175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BROADWAY STE 1800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061652",
            "telephone_number": "212-858-9199",
            "fax_number": "212-858-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BROADWAY STE 1800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10006",
            "telephone_number": "212-858-9199",
            "fax_number": "212-858-9148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Lafayette St Fl 5",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134116",
            "country_code": "US",
            "telephone_number": "212-369-6757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAINWATER",
        "first_name": "NATHAN",
        "middle_name": "PHILIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TN",
            "license": "173978",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "736219",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.