Active NPI
Timothy P Rausch, DMD
- Dentist
- New Madrid, MO
National Provider Identifier
1629138425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE-015440
- Practice address
- 645 US Hwy 61
New Madrid, MO 63869 - Phone
- (573) 748-2225
- Fax
- (573) 748-5655
- NPI assigned
- Dec 11, 2006
- Last updated
- Feb 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE015440 | MO | |
| Dentist | 122300000X | DE-015440 | MO | Primary |
Addresses
Primary practice location
645 US Hwy 61
New Madrid, MO 63869
Mailing address
PO Box 250
645 US Hwy 61
New Madrid, MO 63869
Phone (573) 748-2225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 403746407 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE-015440 | MO | MD | Dentist |
| DE015440 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296604800000",
"number": "1629138425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 250",
"address_2": "645 US HWY 61",
"city": "NEW MADRID",
"state": "MO",
"postal_code": "63869",
"telephone_number": "573-748-2225",
"fax_number": "573-748-5655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 US HWY 61",
"city": "NEW MADRID",
"state": "MO",
"postal_code": "63869",
"telephone_number": "573-748-2225",
"fax_number": "573-748-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAUSCH",
"first_name": "TIMOTHY",
"middle_name": "P",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2011-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "DE015440",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "DE-015440",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "403746407",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Madrid, MO
- New Madrid County Health Dept
- New Madrid County R-1 School District
- New Madrid Pharmacy Inc (New Madrid Pharmacy)
- Pemiscot County Memorial Hospital (Bootheel Primary Care New Madrid)
- Personal Touch
- Blair Ray, DENTAL HYGENIST
- Elizabeth A Riley
- Utisha Robinson, REIKI PROVIDER
- Nannette Jane Rogers Thornton, RD/CDE
- Show-Me Grace in-Home Care Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.