Individual provider Active NPI

Timarie Rayburg, DO

  • Emergency Medicine Physician
  • Allentown, PA
National Provider Identifier
1619139987
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS015056 Issued in PA
Practice address
421 Chew St
Allentown, PA 18102-3406
Phone
(610) 776-4622
Fax
(610) 776-5156
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS015056 PA Primary

Addresses

Primary practice location

421 Chew St
Allentown, PA 18102-3406

Mailing address

PO Box 1754
Allentown, PA 18105-1754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120502000535 PA Practitioner - Emergency Medicine 1951563220 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015056PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Regional Health Network CurrentSince Sep 1, 2018 Accepting new patients
St. Joseph Regional Health Network CurrentSince Sep 1, 2018 Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince Jul 11, 2012 Accepting new patients

Locations

108 Plaza Dr
Blandon, PA 19510
Phone (610) 208-4650

108 Plaza Dr
Ste 101
Blandon, PA 19510
Phone (610) 208-4650

145 N 6th St
Fl 2
Reading, PA 19601
Phone (610) 208-4558

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1619139987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1754",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 CHEW ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023406",
            "telephone_number": "610-776-4622",
            "fax_number": "610-776-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURG",
        "first_name": "TIMARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS015056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.