Individual provider Active NPI

Kathleen S Rathbun-Duncan, D O

  • Family Medicine Physician
  • Greenacres, FL
National Provider Identifier
1639364078
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS7267 Issued in FL
Practice address
4889 Lake Worth Rd
Suite 109
Greenacres, FL 33463-3499
Phone
(561) 649-7532
Fax
(561) 649-7535
NPI assigned
Sep 10, 2007
Last updated
Oct 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS7267 FL Primary

Addresses

Primary practice location

4889 Lake Worth Rd
Suite 109
Greenacres, FL 33463-3499

Mailing address

4889 Lake Worth Rd
Ste 109
Greenacres, FL 33463-3480
Phone (561) 790-4445

Other identifiers 2

IdentifierTypeStateIssuer
000738901MedicaidFL
000738900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20071221000303 FL Practitioner - Family Practice 2769572114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4889 Lake Worth Rd
Suite 109
Greenacres, FL 33463-3480
Phone (561) 649-7532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Imaging, LLC CurrentSince Apr 15, 2012 Accepting new patients
Independent Imaging LLC CurrentSince Apr 15, 2012 Accepting new patients
Palm Beach Family Medical Associates Inc CurrentSince May 16, 2005 Accepting new patients
Western Communities Family Practice Assoc Inc Family Medicine Past Accepting new patients
R a M Medical Inc Past Accepting new patients

Locations

4889 Lake Worth Rd
Ste 109
Greenacres, FL 33463
Phone (561) 649-7532

5700 Lake Worth Rd
Ste 103
Greenacres, FL 33463
Phone (561) 296-2345

13005 Southern Blvd
Ste 213
Loxahatchee, FL 33470
Phone (561) 254-7933

3347 S State Road 7
Ste 100
Wellington, FL 33449
Phone (561) 795-5558

Interoperability endpoints

  • Direct secure messaging: kathleen.rathbun.1@18813.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1639364078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4889 LAKE WORTH RD",
            "address_2": "STE 109",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633480",
            "telephone_number": "561-790-4445",
            "fax_number": "561-790-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4889 LAKE WORTH RD",
            "address_2": "SUITE 109",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633499",
            "telephone_number": "561-649-7532",
            "fax_number": "561-649-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHBUN-DUNCAN",
        "first_name": "KATHLEEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000738901",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000738900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.