Fred Allen Rayburn Jr., FNP - BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903556 Issued in MS

Practice address

848 S Madison St
Tupelo, MS 38801-4905

Phone

(662) 844-4177

NPI assigned

Sep 26, 2019

Last updated

Sep 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology and Hypertension Associates LTDGroup PAC ID 1254327554, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
• Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099
• Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: frayburn30317@direct.acumenmd.com
• Direct secure messaging: fredrayburn@nmhs.medalliesdirect.net
• FHIR API: https://fhir4.healow.com/fhir/r4/JADIBA

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.

• Nephrology & Hypertension Associates, LTD.

  • Nephrology Physician
  • Tupelo, MS
  • NPI 1902975139
  Medicare reassignment Care Compare group NPD
• Midnight-Medical, Inc.

  • Family Nurse Practitioner
  • Tupelo, MS
  • NPI 1770727257
  Medicare reassignment NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD

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

• Baptist Memorial Hospital North Mississippi, Inc

  • General Acute Care Hospital
  • Oxford, MS
  • NPI 1053375576
  Care Compare affiliation
• North Mississippi Medical Center, Inc.

  dba North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  dba UMMC Greenwood Hospital

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Care Compare affiliation

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1700437076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 TOXISH RD",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388637080",
            "telephone_number": "662-488-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-844-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "FRED",
        "middle_name": "ALLEN",
        "name_suffix": "Jr.",
        "credential": "FNP - BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Max Patrick Rash
• Melissa Clytee Ratliff-Sorrell, LCSW
• Kara Ratliff
• Gina M Ray, MA
• Mark Ray, M.D.
• Harry J Rayburn, D.M.D
• Vernon A Rayford, M.D.
• Ali Raza
• Samina Raza
• Zareen Razaq

• Family Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.