William Rayburn, MD, MBA

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD83276 Issued in SC

Practice address

103 Palm Blvd Ste 2a
Isle of Palms, SC 29451-2165

Phone

(843) 800-1303

Fax

(888) 316-7716

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Psychiatry

Education

University of Kentucky College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sweetgrass Psychiatry LLCGroup PAC ID 4688932957, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.rayburn.1@15910.direct.athenahealth.com

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.

• Sweetgrass Psychiatry LLC

  • Psychiatry Physician
  • Mount Pleasant, SC
  • NPI 1669985859
  Medicare reassignment Care Compare group NPD
• Unm Medical Group Inc

  • Developmental Disabilities Clinic/Center
  • Albuquerque, NM
  • NPI 1851614432
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1922015999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 JOHNNIE DODDS BLVD",
            "address_2": "STE 200",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643045",
            "telephone_number": "843-800-1303",
            "fax_number": "888-316-7716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PALM BLVD STE 2A",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "294512165",
            "telephone_number": "843-800-1303",
            "fax_number": "888-316-7716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Johnnie Dodds Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643045",
            "country_code": "US",
            "telephone_number": "843-800-1303",
            "fax_number": "888-316-7716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "99-106",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "MD83276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Marsh, P T
• Neil S Oconnor
• Joe D. Newton, REGISTER PHARMACIST
• Quercus Counseling, LLC
• Glennis Randazzo, GLENNIS RANDAZZO
• Caroline Rice
• Elissa Reilly Slater, BSN RN
• Caroline Sledden, RDN, LDN
• Teeth DS Isle of Palms
• Teeth DS Isle of Palms

• Child & Adolescent Psychiatry Physician in Isle of Palms, SC
• Providers in Isle of Palms, SC by specialty
• Child & Adolescent Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.