Individual provider Active NPI

Chris B Rathburn, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1548244403
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME43492 Issued in FL
Practice address
7011 A C Skinner Pkwy
Suite 160
Jacksonville, FL 32256-6954
Phone
(904) 622-9035
Fax
(904) 493-2222
NPI assigned
Dec 5, 2005
Last updated
Dec 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME43492 FL Primary

Addresses

Primary practice location

7011 A C Skinner Pkwy
Suite 160
Jacksonville, FL 32256-6954

Mailing address

PO Box 551308
Jacksonville, FL 32255-1308
Phone (904) 493-3333

Other identifiers 1

IdentifierTypeStateIssuer
P00677713OtherFLRAILROAD MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Urgent Care Mandarin LLC Past Accepting new patients
Chris B Rathburn MD PA Internal Medicine PastSince May 1, 2001 Accepting new patients

Organizations & group practices 2

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1548244403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551308",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551308",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 A C SKINNER PKWY",
            "address_2": "SUITE 160",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566954",
            "telephone_number": "904-622-9035",
            "fax_number": "904-493-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHBURN",
        "first_name": "CHRIS",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME43492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00677713",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.