Samuel Thomas Rayburn, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

E-2209 Issued in AR

Practice address

10100 Kanis Rd
Little Rock, AR 72205-6202

Phone

(501) 223-5757

Fax

(501) 223-5758

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery

Education

University of Mississippi School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jack Stephens Heart Institute LLCGroup PAC ID 1355512708, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srayburn458106@direct.stlukeshealth.org

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.

• Jack Stephens Heart Institute LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Little Rock, AR
  • NPI 1033404199
  Medicare reassignment Care Compare group NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016

  Surgery

  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Child & Adolescent Psychiatry Physician
  • North Little Rock, AR
  • NPI 1750456638
  NPD
• Watkins, Bauer & Meadors, P.a.

  dba Cardiovascular Surgeons, P.A.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Little Rock, AR
  • NPI 1811073604
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Vincent Infirmary Medical Center

  dba St Vincent Infirmary Medical Center - GeroPsych Unit

  • Psychiatric Hospital Unit
  • Little Rock, AR
  • NPI 1710442801
  Care Compare affiliation
• St Vincent Infirmary Medical Center

  dba St. Vincent Health System

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1780684431
  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1629017587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-223-5757",
            "fax_number": "501-223-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-223-5757",
            "fax_number": "501-223-5758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 713",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "fax_number": "501-686-5323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4110 Outpatient Circle",
            "address_2": "Slot 616",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "72205",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "fax_number": "501-686-5323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "SAMUEL",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2023-05-04",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-2209",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AR",
            "license": "E-2209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137308001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trenda Dayle Ray, APN
• Khalid Rayaz, M.D
• Romana Rayaz, M.D.
• Brian Michael Rayburn, PA-C
• Katia Rayburn, APRN
• Holly Stracner Raycher, M.S.
• Hamza Rayes, MD,FACC,RPVI,CBCCT
• Raymond R Remmel MD PA
• Sania Razzaq, MD
• RDP Laboratories, LLC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.