Individual provider Active NPI

John Anthony Racanelli, MD

  • Orthopaedic Surgery Physician
  • Dallas, TX
National Provider Identifier
1619986692
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
H5479 Issued in TX
Practice address
8210 Walnut Hill LN
Ste 130, LB 11
Dallas, TX 75231-4418
Phone
(214) 750-1207
Fax
(214) 739-5029
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X H5479 TX Primary
Orthopaedic Surgery Physician 207X00000X 09332R LA

Addresses

Primary practice location

8210 Walnut Hill LN
Ste 130, LB 11
Dallas, TX 75231-4418

Mailing address

8210 Walnut Hill LN
Ste 130, LB 11
Dallas, TX 75231-4418
Phone (214) 750-1207

Other identifiers 3

IdentifierTypeStateIssuer
103395302MedicaidTX
82V191OtherTXBCBS
103395301MedicaidTX

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

State licenses

LicenseStateTypeSpecialty
09332RLAMDOrthopaedic Surgery Physician
H5479TXMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1619986692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LN",
            "address_2": "STE 130, LB 11",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314418",
            "telephone_number": "214-750-1207",
            "fax_number": "214-739-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LN",
            "address_2": "STE 130, LB 11",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314418",
            "telephone_number": "214-750-1207",
            "fax_number": "214-739-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACANELLI",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "H5479",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "09332R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103395302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82V191",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103395301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.