Clive B Rayner, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN8951 Issued in FL

Practice address

2301 Park Ave
Suite 101
Orange Park, FL 32073-5565

Phone

(904) 269-5195

Fax

(904) 269-7196

NPI assigned

Mar 24, 2006

Sex

Male

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 1

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: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 1, 2012 through Dec 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1922068824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 PARK AVE",
            "address_2": "SUITE 101",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735565",
            "telephone_number": "904-269-5195",
            "fax_number": "904-269-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 PARK AVE",
            "address_2": "SUITE 101",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735565",
            "telephone_number": "904-269-5195",
            "fax_number": "904-269-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNER",
        "first_name": "CLIVE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN8951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "67978",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Renee Rasmussen
• Robert Franklin Raspa, M.D.
• Taha Faiz Rasul, MD
• Stacey Raulerson, PTA
• Meagan Rawers, PHARMD
• Hafiz Ali Raza, M.B.B.S
• Imad Raza
• Mohsin Raza
• Muhammad Waleed Raza, M.D.
• RCCN Pain Management LLC

• Oral and Maxillofacial Surgery (Dentist) in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.