Angela D. Rayburn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-C05-TA-838 Issued in AL

Practice address

55292 Highway 17
Sulligent, AL 35586

Phone

(205) 698-7020

NPI assigned

Sep 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Southern Focus, Inc.

  • Optometrist
  • Sulligent, AL
  • NPI 1255661070

  AL, Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1831423680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335",
            "city": "SULLIGENT",
            "state": "AL",
            "postal_code": "355860335",
            "telephone_number": "205-698-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55292 HIGHWAY 17",
            "city": "SULLIGENT",
            "state": "AL",
            "postal_code": "35586",
            "telephone_number": "205-698-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "ANGELA",
        "middle_name": "D.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-C05-TA-838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "102I413114",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/DME SUPPLIER PTAN",
            "identifier": "6343010001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Medical Center Inc.
• NWMC Lamar Regional Health Center Radiology
• NWMC Winfield Phys-Lamar Reg HC Group
• NWMC-Winfield Physician Practices, LLC
• Premise Health of Alabama Medical PC
• Charles D Rubley, CRNP
• Southern Focus, Inc.
• Wendy Jill White, REGISTERED NURSE

• All providers in Sulligent, AL
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.