Provider Demographics
NPI:1366448078
Name:RAGON, JAMES R (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:RAGON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PARKVIEW CV
Mailing Address - Street 2:
Mailing Address - City:PIPERTON
Mailing Address - State:TN
Mailing Address - Zip Code:38017-5389
Mailing Address - Country:US
Mailing Address - Phone:901-755-8516
Mailing Address - Fax:
Practice Address - Street 1:45 PARKVIEW CV
Practice Address - Street 2:
Practice Address - City:PIPERTON
Practice Address - State:TN
Practice Address - Zip Code:38017-5389
Practice Address - Country:US
Practice Address - Phone:901-755-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51354367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2370269Medicaid
TN3600575Medicaid
IN200458090AMedicaid
VA008950261Medicaid
LA1978701Medicaid
WI82636200Medicaid
SCQAN018Medicaid
IA0716241Medicaid
OR274931Medicaid
ME422400000Medicaid
MO916802622Medicaid
OK100783150AMedicaid
MT4303442Medicaid
MS00126560Medicaid
TX055031102Medicaid
MI104802080Medicaid
AR124635701Medicaid
WI82636200Medicaid