Rodney Ralston Abrahams I, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401004749 Issued in VA

Practice address

204 Campbell LN
Tazewell, VA 24651

Phone

(276) 979-1121

Fax

(276) 979-1121

NPI assigned

Jul 17, 2006

Last updated

Jul 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in VA

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

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1619995933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "246510132",
            "telephone_number": "276-979-1121",
            "fax_number": "276-979-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CAMPBELL LN",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "24651",
            "telephone_number": "276-979-1121",
            "fax_number": "276-979-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAMS",
        "first_name": "RODNEY",
        "middle_name": "RALSTON",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401004749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "176747",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007808411",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "140394",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA METLIFE",
            "identifier": "541050295",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Adair
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• Richard Allen Bare, LCSW, LCAS

• General Practice Dentistry in Tazewell, VA
• Providers in Tazewell, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.