Ravenhill Dermatology Medical Clinic, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RAVENHILL DERMATOLOGY MEDICAL CLINIC, P.C.

Practice address

110 Barcelona Dr
Fayetteville, NC 28303-4453

Phone

(910) 485-4101

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Debbie Reinelt

Title

Billing

Phone

(828) 891-5524

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenya Demeta Bass, PA-C

  • Medical Physician Assistant
  • Fayetteville, NC
  • NPI 1942387485
  NPD (past)
• Lana Smith Vanstory, MPAS, PA-C

  • Physician Assistant
  • Wilson, NC
  • NPI 1407907181
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1962519462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BARCELONA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BARCELONA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034453",
            "telephone_number": "910-485-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENHILL DERMATOLOGY MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "REINELT",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "828-891-5524"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "83124",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8983124",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florence Vimala Rathinam, CERTIFIED GNP
• Dehasia Ratliff
• Lee Graham Raudenbush, PA
• Raju B Raval, DO
• Daniel Raymond Ravel, DDS
• Abrar Raviv, DO
• Anuva Ray
• Carlotta Harrington Ray, M.A., LCMHC
• Charlene A Ray, MSN, ANP-C
• Heather Louise Ray, PTA

• Dermatology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.