Lon Chad McRae, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D3214 Issued in ID

Practice address

1067 S Wells St
Meridian, ID 83642-7997

Phone

(208) 895-8486

Fax

(208) 895-8540

NPI assigned

Nov 29, 2006

Last updated

Oct 14, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• McRae Dental PA

  • Dental Clinic/Center
  • Meridian, ID
  • NPI 1184884348
  Authorized official Same address or phone

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1558438903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 S. WELLS ST.",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-895-8486",
            "fax_number": "208-895-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 S WELLS ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427997",
            "telephone_number": "208-895-8486",
            "fax_number": "208-895-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "LON",
        "middle_name": "CHAD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805008600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy McMurray, DPT
• James McMurray, DPT
• John Driggs McMurray, DDS
• McRae Dental PA
• John McRae, DNP
• Kevin Bernard McSweeney, O.D.
• Judson Robert Mead, PA
• Sandra D Meador, ATC, LAT
• Lawrence Wayne Meadors, D.M.D.
• Meadow Lake Surgery Center Inc

• Dentist in Meridian, ID
• Providers in Meridian, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.