Active NPI
John Paul Rahart, DDS
- Dentist
- Bosque, NM
National Provider Identifier
1558413377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD2034
- Practice address
- 384 Highway 116
Bosque, NM 87006-9703 - Phone
- (505) 864-6587
- NPI assigned
- Jan 18, 2007
- Last updated
- Jul 9, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD2034 | NM | Primary |
Addresses
Primary practice location
384 Highway 116
Bosque, NM 87006-9703
Mailing address
384 Highway 116
Bosque, NM 87006-9703
Phone (505) 864-6587
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0010100 | Medicaid | NM | |
| B7538 | Medicaid | NM |
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 |
|---|---|---|---|
| DD2034 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1558413377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "384 HIGHWAY 116",
"city": "BOSQUE",
"state": "NM",
"postal_code": "870069703",
"telephone_number": "505-864-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "384 HIGHWAY 116",
"city": "BOSQUE",
"state": "NM",
"postal_code": "870069703",
"telephone_number": "505-864-6587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHART",
"first_name": "JOHN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD2034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0010100",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "B7538",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bosque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.