Jack W Raby, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DPO 446 Issued in TN

Practice address

343 Gill St
Alcoa, TN 37701-2415

Phone

(865) 982-5317

Fax

(865) 982-5935

NPI assigned

Jan 4, 2007

Last updated

Sep 24, 2009By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jack Raby Optical

  • Durable Medical Equipment & Medical Supplies
  • Alcoa, TN
  • NPI 1760652291
  NPD (past) Authorized official

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1801943733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 GILL ST",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012415",
            "telephone_number": "865-982-5317",
            "fax_number": "865-982-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 GILL ST",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012415",
            "telephone_number": "865-982-5317",
            "fax_number": "865-982-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABY",
        "first_name": "JACK",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TN",
            "license": "DPO 446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Nicole Pollock, CPHT
• Jennifer Ponce Fernandez
• Autumn Potter, PHARMD
• Eric Leigh Poulsen, M.ED
• Jenna Hope Poynter, CNA
• Fredric M Radoff, MD
• Charles L Rahn, M.D.
• Erika Paige Ramsdale, PHARM.D.
• Benjamin Harmon Rasnick, D.C.
• Kaitlyn Elizabeth Reid, PT, DPT

• Optician in Alcoa, TN
• Providers in Alcoa, TN by specialty
• Optician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.