Active NPI
Jonathan Mark Raines, M.D.
- Psychiatry Physician
- Gladwyne, PA
National Provider Identifier
1720444581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD029406E
- Practice address
- 1629 Monk Rd
Gladwyne, PA 19035-1349 - Phone
- (610) 649-8717
- NPI assigned
- Jan 10, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD029406E | PA | Primary |
Addresses
Primary practice location
1629 Monk Rd
Gladwyne, PA 19035-1349
Mailing address
PO Box 470
Gladwyne, PA 19035-0470
Phone (610) 649-8717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 1998 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD029406E | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452384000000",
"number": "1720444581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 470",
"city": "GLADWYNE",
"state": "PA",
"postal_code": "190350470",
"telephone_number": "610-649-8717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1629 MONK RD",
"city": "GLADWYNE",
"state": "PA",
"postal_code": "190351349",
"telephone_number": "610-649-8717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINES",
"first_name": "JONATHAN",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-10",
"last_updated": "2016-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD029406E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladwyne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.