Individual provider Active NPI

Raymond Valdes, M.D.

  • Internal Medicine Physician
  • West Memphis, AR
National Provider Identifier
1508817719
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0E2536 Issued in AR
Practice address
208 Shoppingway Blvd
Suite a
West Memphis, AR 72301-1734
Phone
(870) 733-1280
Fax
(870) 733-9443
NPI assigned
May 12, 2006
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000034563 TN
Internal Medicine Physician 207R00000X 0E2536 AR Primary

Addresses

Primary practice location

208 Shoppingway Blvd
Suite a
West Memphis, AR 72301-1734

Mailing address

208 Shoppingway Blvd Ste a
Suite a
West Memphis, AR 72301-1734
Phone (870) 733-1280

Other identifiers 2

IdentifierTypeStateIssuer
1782327MedicaidLA
140122001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040817000939 AR Practitioner - Internal Medicine 4688647712 Practice locations: West Memphis, AR
I20040930000731 TN Practitioner - Internal Medicine 4688647712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0E2536ARMDInternal Medicine Physician
MD0000034563TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harper Medical Group, PC CurrentSince Jan 1, 2022 Accepting new patients

Locations

5475 Poplar Ave
Ste 106
Memphis, TN 38119
Phone (901) 254-8040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1508817719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SHOPPINGWAY BLVD STE A",
            "address_2": "SUITE A",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011734",
            "telephone_number": "870-733-1280",
            "fax_number": "877-441-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SHOPPINGWAY BLVD",
            "address_2": "SUITE A",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011734",
            "telephone_number": "870-733-1280",
            "fax_number": "870-733-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "RAYMOND",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000034563",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "0E2536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1782327",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140122001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.