Individual provider Active NPI

Christine Raines, PH.D.

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1831590082
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5527 Issued in NC
Practice address
1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171
Phone
(704) 910-8381
Fax
(704) 981-8282
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P.07607 OH
Clinical Psychologist 103TC0700X 5527 NC Primary

Addresses

Primary practice location

1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171

Mailing address

1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171
Phone (704) 910-8381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 21, 2019 through Oct 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P.07607OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Base, PLLC PastSince Aug 11, 2019 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1831590082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINES",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.07607",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.