Active NPI
Mythili Rajan, M.D.
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1962453977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23075
- Practice address
- 3024 New Bern Ave
Raleigh, NC 27610-1247 - Phone
- (919) 350-8009
- Fax
- (919) 350-8147
- NPI assigned
- May 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23075 | NC | Primary |
Addresses
Primary practice location
3024 New Bern Ave
Raleigh, NC 27610-1247
Mailing address
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone (919) 350-8009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23075 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328486400000",
"number": "1962453977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101247",
"telephone_number": "919-350-8009",
"fax_number": "919-350-8147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3024 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101247",
"telephone_number": "919-350-8009",
"fax_number": "919-350-8147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJAN",
"first_name": "MYTHILI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-14",
"last_updated": "2012-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "23075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.