Raine William Pendarvis, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

046803 Issued in GA

Practice address

3107 Watsons BND
Alpharetta, GA 30004-8825

Phone

(678) 691-0487

Fax

(678) 691-0487

NPI assigned

Dec 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Northside Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1013960657

  Diagnostic Radiology, GA

  Medicare reassignment NPD
• Quantum Medical Radiology PC

  • Diagnostic Radiology Physician
  • Smyrna, GA
  • NPI 1164475869

  Diagnostic Radiology, GA

  Medicare reassignment NPD
• Associated Radiologists, LTD.

  • Diagnostic Radiology Physician
  • Jonesboro, AR
  • NPI 1215931290

  Diagnostic Radiology, GA

  Medicare reassignment NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812

  Diagnostic Radiology, GA

  Medicare reassignment NPD
• Brfhh Monroe LLC

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1811324882

  Family Medicine, GA

  Medicare reassignment NPD
• Coastal Radiology Associates, PLLC

  • Diagnostic Radiology Physician
  • New Bern, NC
  • NPI 1144270307

  Diagnostic Radiology, GA

  Medicare reassignment NPD
• Greensboro Radiology, PA

  • Diagnostic Radiology Physician
  • Greensboro, NC
  • NPI 1821035999

  Diagnostic Radiology, GA

  Medicare reassignment NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Anaheim, CA
  • NPI 1972826774

  Diagnostic Radiology

  NPD
• Bay Radiology Associates, PL

  • Diagnostic Radiology Physician
  • Panama City, FL
  • NPI 1538136395

  Diagnostic Radiology

  NPD (past)
• Bay Radiology Womens Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Panama City, FL
  • NPI 1720238769

  Diagnostic Radiology

  NPD (past)
• Blue Ridge Radiology, P.C.

  • Diagnostic Radiology Physician
  • Bristol, TN
  • NPI 1881687689

  Diagnostic Radiology

  NPD (past)
• Clinch Valley Physicians Inc

  • Multi-Specialty Clinic/Center
  • Richlands, VA
  • NPI 1912980855
  NPD (past)

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1760467005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 WATSONS BND",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048825",
            "telephone_number": "678-691-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 WATSONS BND",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048825",
            "telephone_number": "678-691-0487",
            "fax_number": "678-691-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDARVIS",
        "first_name": "RAINE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "15628",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036110696",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME84545",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "24145",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "046803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrics & Genetics, LLC
• Pedpost Foundation Inc
• David M Pehrson, D.M.D.
• Ariella Peist, LCSW
• Kelsey Alexa Pelletier, PT, DPT
• Raina Penkar
• Kenique D Penn, LPC
• Ashley Penney, FNP-BC
• Amanda Lin Pennington
• Larue D Penny Jr., M.D.

• All providers in Alpharetta, GA
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.

Verify at the official NPI Registry.