Provider Demographics
NPI:1427040831
Name:RAINES, ROBERT A JR (MM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:RAINES
Suffix:JR
Gender:M
Credentials:MM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 HARRISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-7650
Mailing Address - Fax:513-751-0023
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3045
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-751-0023
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075936R207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4419391OtherCIGNA
OH0901249OtherUNITED HEALTHCARE
OH2122278Medicaid
OH000000038976OtherANTHEM
OH105030700OtherUS DEPT OF LABOR
OH311643349OtherPRIVATE
OH311643349OtherPRIVATE
OHG94604Medicare UPIN
OH200036161Medicare PIN