Active NPI
Chris Rairdon
- Social Worker
- Ukiah, CA
National Provider Identifier
1528449972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 59682
- Practice address
- 350 E Gobbi St
Ukiah, CA 95482-5511 - Phone
- (707) 472-2922
- Fax
- (707) 462-1381
- NPI assigned
- Jun 11, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | ACSW95682 | CA | |
| Social Worker | 104100000X | 59682 | CA | Primary |
Addresses
Primary practice location
350 E Gobbi St
Ukiah, CA 95482-5511
Mailing address
PO Box 2077
Ukiah, CA 95482-2077
Phone (707) 472-2922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACSW95682 | CA | MD | Counselor |
| 81498 | CA | MD | Pharmacist |
| 59682 | CA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Current | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
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.
-
- Mental Health Counselor
- San Jose, CA
- NPI 1154994846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1528449972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2077",
"city": "UKIAH",
"state": "CA",
"postal_code": "954822077",
"telephone_number": "707-472-2922",
"fax_number": "707-462-1381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 E GOBBI ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954825511",
"telephone_number": "707-472-2922",
"fax_number": "707-462-1381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIRDON",
"first_name": "CHRIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-11",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "ACSW95682",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "59682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.