Individual provider Active NPI

Richard B Rankin, MD

  • Diagnostic Radiology Physician
  • Lodi, CA
National Provider Identifier
1881603017
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G54313 Issued in CA
Practice address
1121 W Vine Street
Suite 15
Lodi, CA 95240
Phone
(209) 334-4416
Fax
(209) 371-0119
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G54313 CA Primary

Addresses

Primary practice location

1121 W Vine Street
Suite 15
Lodi, CA 95240

Mailing address

PO Box 15498
Sacramento, CA 95857
Phone (559) 455-4000

Other identifiers 1

IdentifierTypeStateIssuer
00G543130MedicaidCA

Other names 1

  • Brandon R. Rankin III Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071020000152 CA Practitioner - Diagnostic Radiology 8527154608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.97 of 100Reported as group
Quality
91.92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54313CAMDGeneral Practice Dentistry
G54313CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Gate Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Apr 1, 2007 Accepting new patients
Golden Gate Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Apr 1, 2007 Accepting new patients
Delta Radiology, Inc. CurrentSince Jan 1, 2005 Accepting new patients
Delta Radiology, Inc. CurrentSince Jan 1, 2005 Accepting new patients

Locations

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

541 S Ham Ln
Ste B
Lodi, CA 95242
Phone (209) 224-8940

1031 S Fairmont Ave
Lodi, CA 95240
Phone (209) 333-7422

1121 W Vine St
Ste 16
Lodi, CA 95240
Phone (209) 263-0200

1121 W Vine St
Ste 15
Lodi, CA 95240
Phone (209) 333-7422

845 Jackson St
San Francisco, CA 94133
Phone (415) 677-2300

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

10200 Trinity Pkwy
Ste 204
Stockton, CA 95219
Phone (209) 451-3920

1617 N California St
Ste 1B
Stockton, CA 95204
Phone (209) 948-6063

Organizations & group practices 4

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1881603017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15498",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95857",
            "telephone_number": "559-455-4000",
            "fax_number": "559-455-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W VINE STREET",
            "address_2": "SUITE 15",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95240",
            "telephone_number": "209-334-4416",
            "fax_number": "209-371-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKIN",
        "first_name": "RICHARD",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G54313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G543130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON",
            "last_name": "RANKIN",
            "middle_name": "R.",
            "suffix": "III",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.