Active NPI
John M Raines, M.D.
- Otolaryngology Physician
- Phoenix, AZ
National Provider Identifier
1629048608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 11267
- Practice address
- 2222 E. Highland Ave
Suite 204
Phoenix, AZ 85016-4876 - Phone
- (602) 257-4219
- Fax
- (602) 257-8319
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 11267 | AZ | Primary |
Addresses
Primary practice location
2222 E. Highland Ave
Suite 204
Phoenix, AZ 85016-4876
Mailing address
2222 E. Highland Ave
Suite 204
Phoenix, AZ 85016-4876
Phone (602) 257-4219
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 799702 | Medicaid | AZ | |
| 231283 | Medicaid | AZ | |
| AZ0819110 | Other | AZ | BC/BS PROVIDER ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11267 | AZ | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1629048608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 E. HIGHLAND AVE",
"address_2": "SUITE 204",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850164876",
"telephone_number": "602-257-4219",
"fax_number": "602-257-8319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 E. HIGHLAND AVE",
"address_2": "SUITE 204",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850164876",
"telephone_number": "602-257-4219",
"fax_number": "602-257-8319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINES",
"first_name": "JOHN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AZ",
"license": "11267",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "799702",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "231283",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER ID",
"identifier": "AZ0819110",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.