Active NPI
Edwin A Raines, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Memphis, TN
National Provider Identifier
1811971856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 007545
- Practice address
- 1211 Union Ave
Suite 300
Memphis, TN 38104-6638 - Phone
- (901) 725-7551
- Fax
- (901) 725-9721
- NPI assigned
- Dec 2, 2005
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 007545 | TN | Primary |
Addresses
Primary practice location
1211 Union Ave
Suite 300
Memphis, TN 38104-6638
Mailing address
1211 Union Ave
Suite 300
Memphis, TN 38104-6638
Phone (901) 725-7551
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3041510 | Medicaid | TN |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151111002106 | MS | Practitioner - Pathology | 8224217708 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007545 | TN | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198713600000",
"number": "1811971856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 UNION AVE",
"address_2": "SUITE 300",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046638",
"telephone_number": "901-725-7551",
"fax_number": "901-725-9721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 UNION AVE",
"address_2": "SUITE 300",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046638",
"telephone_number": "901-725-7551",
"fax_number": "901-725-9721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINES",
"first_name": "EDWIN",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2007-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TN",
"license": "007545",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3041510",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.