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Individual provider Active NPI

Mary Yvonne Rayborn, MD

  • Family Medicine Physician
  • Sioux Center, IA
National Provider Identifier
1992865828
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36126 Issued in IA
Practice address
1101 9TH St SE
Sioux Center, IA 51250-2501
Phone
(712) 722-2609
Fax
(712) 722-8394
NPI assigned
Dec 11, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36126 IA Primary

Addresses

Primary practice location

1101 9TH St SE
Sioux Center, IA 51250-2501

Mailing address

1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (712) 722-2609

Other practice location 1

645 S Main Ave
Sioux Center, IA 51250-1347
Phone (712) 722-2609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220421001625 MO Practitioner - Family Practice 8820028723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oral Roberts University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

510 Hwy 32
Suite C
Lebanon, MO 65536-5303
Phone (417) 269-2278

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36126IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Family Medicine Current Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince May 23, 2022 Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince May 23, 2022 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients
Lester E Cox Medical Centers Family Medicine PastSince Jul 21, 2024 Accepting new patients

Locations

3203 E Old Stone Ave
Brookline, MO 65619
Phone (417) 269-1910

510 Highway 32
Ste C
Lebanon, MO 65536
Phone (417) 269-2278

3801 S National Ave
Ste 1122
Springfield, MO 65807

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1992865828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-2609",
            "fax_number": "712-722-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-2609",
            "fax_number": "712-722-8394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 S Main Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Center",
            "state": "IA",
            "postal_code": "512501347",
            "country_code": "US",
            "telephone_number": "712-722-2609",
            "fax_number": "712-722-8394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYBORN",
        "first_name": "MARY",
        "middle_name": "YVONNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "36126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Center, IA

Sources for this page

Verify at the official NPI Registry.