Active NPI
Judy A Raeth, RDMS
- Sonography Radiologic Technologist
- Camdenton, MO
National Provider Identifier
1508004987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sonography Radiologic Technologist
- License
- 29559
- Practice address
- 1061 Thunder Mt. Rd.
Camdenton, MO 65020 - Phone
- (573) 480-0555
- NPI assigned
- Jan 23, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Sonography Radiologic Technologist | 2471S1302X | 29559 | FL | Primary |
Addresses
Primary practice location
1061 Thunder Mt. Rd.
Camdenton, MO 65020
Mailing address
1061 Thunder Mt. Rd.
Camdenton, MO 65020
Phone (573) 480-0555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29559 | FL | MD | Sonography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1508004987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 THUNDER MT. RD.",
"city": "CAMDENTON",
"state": "MO",
"postal_code": "65020",
"telephone_number": "573-480-0555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 THUNDER MT. RD.",
"city": "CAMDENTON",
"state": "MO",
"postal_code": "65020",
"telephone_number": "573-480-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAETH",
"first_name": "JUDY",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "RDMS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-23",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "2471S1302X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Sonography",
"state": "FL",
"license": "29559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camdenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.