DR. JORDAN DARYL RAINE MD
NPI 1235716416
Student in an Organized Health Care Education/Training Program in Chattanooga, TN

Q: What is Jordan Raine's NPI number?

The NPI number for Jordan Raine is 1235716416. It was assigned to this individual provider in the NPPES registry on March 25, 2021.

Q: What is Jordan Raine's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Raine was last updated on March 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 25, 2021PECOS Enrolled

979 E 3RD ST STE B-401, CHATTANOOGA, TN 37403(423) 778-7695 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Jordan Daryl Raine Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JORDAN DARYL RAINE MD (NPI 1235716416) is an individual student in an organized health care education/training program in Chattanooga, Tennessee and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235716416

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. JORDAN DARYL RAINECredential: MD

Location Address979 E 3RD ST STE B-401Chattanooga, TN 37403-2136

Mailing Address979 E 3rd St Ste B-401Chattanooga, TN 37403-2136 · (423) 778-7695

Phone(423) 778-7695

Sole ProprietorNo

Enumeration DateMarch 25, 2021

NPPES CertifiedMarch 25, 2021

✔ NPI 1235716416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

979 E 3RD ST STE B-401, Chattanooga, TN 37403

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jordan Daryl Raine Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLINE CORASON MD

Student in an Organized Health Care Education/Training Program