Active NPI
Jordan Micheal Raya, D.P.T
- Physical Medicine & Rehabilitation Physician
- Lodi, CA
National Provider Identifier
1780002832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- PT41208
- Practice address
- 631 S Ham LN
Lodi, CA 95242-3532 - Phone
- (209) 368-7433
- Fax
- (209) 368-4219
- NPI assigned
- Apr 4, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PT41208 | CA | Primary |
Addresses
Primary practice location
631 S Ham LN
Lodi, CA 95242-3532
Mailing address
631 S Ham LN
Lodi, CA 95242-3532
Phone (209) 368-7433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT41208 | CA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396569600000",
"number": "1780002832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 S HAM LN",
"city": "LODI",
"state": "CA",
"postal_code": "952423532",
"telephone_number": "209-368-7433",
"fax_number": "209-368-4219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 S HAM LN",
"city": "LODI",
"state": "CA",
"postal_code": "952423532",
"telephone_number": "209-368-7433",
"fax_number": "209-368-4219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYA",
"first_name": "JORDAN",
"middle_name": "MICHEAL",
"credential": "D.P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-04",
"last_updated": "2014-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "PT41208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.