Individual provider Active NPI

Pamela Dawn Raines, APRN

  • Gerontology Nurse Practitioner
  • Springfield, OH
National Provider Identifier
1699382580
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.0027563 Issued in OH
Practice address
100 W McCreight Ave Ste 110
Springfield, OH 45504-1890
Phone
(937) 523-9940
Fax
(937) 523-9935
NPI assigned
Sep 25, 2020
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.0027563 OH Primary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.0027563 OH

Addresses

Primary practice location

100 W McCreight Ave Ste 110
Springfield, OH 45504-1890

Mailing address

100 W McCreight Ave Ste 110
Springfield, OH 45504-1890
Phone (937) 523-9940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316002513 OH Practitioner - Nurse Practitioner 4789090796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Springfield Specialty Care LLCGroup PAC ID 4284059981, 129 clinicians

Practice addresses (Care Compare)

100 W McCreight Ave
Suite 110
Springfield, OH 45504-1890
Phone (937) 717-4884

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027563OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Springfield Specialty Care LLC CurrentSince Jan 16, 2022 Accepting new patients
Gcga Physicians Inc. PastSince Feb 8, 2021 Accepting new patients

Locations

100 W McCreight Ave
Ste 110
Springfield, OH 45504
Phone (937) 717-4884

900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666

Interoperability endpoints

  • Direct secure messaging: praines848963@direct.bsmhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1699382580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W MCCREIGHT AVE STE 110",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455041890",
            "telephone_number": "937-523-9940",
            "fax_number": "937-523-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MCCREIGHT AVE STE 110",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455041890",
            "telephone_number": "937-523-9940",
            "fax_number": "937-523-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINES",
        "first_name": "PAMELA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0027563",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.0027563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.