HENRY III RAINBOLT (PA-C) – Physician Assistant, NPI 1134769367

HENRY III RAINBOLT (PA-C) is a healthcare provider. based in Columbia, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA-2721 (ID). The NPI Number for HENRY III RAINBOLT (PA-C) is 1134769367

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
HENRY III RAINBOLT (PA-C)
NPI
1134769367
Phone
(573) 499-4990
Address
105 N KEENE ST
Enumeration Date
15 January 2020
Last Update Date
24 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2089334442
Graduation Year
2019 (7 years ago)
PAC ID
6709214760
Group Practice PAC ID
8527381136
Professional Enrollment ID
I20240312003352
Address ID
ID833013310TW1309XNXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,854 PHYSICIAN ASSISTANT in MO

Provider Addresses for HENRY III RAINBOLT (PA-C)

  • 105 N KEENE ST

    COLUMBIA, MO 652018131

    Phone: (573) 499-4990

    Type: Mailing

  • 1035 PLACER ST

    REDDING, CA 960011170

    Phone: (530) 246-5710

    Type: Mailing

  • 382 N OVERLAND AVE

    BURLEY, ID 833183433

    Phone: (208) 933-4442

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240312003352IPhysician AssistantIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527381136View full group profile
NameSpecialtyState
Physician AssistantID
Physician AssistantID
-ID
Nurse PractitionerID
Physician AssistantID
Family PracticeID
Family PracticeID
Nurse PractitionerID
Physician AssistantID
Physician AssistantID

Reviews

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Frequently asked questions

What identifier follows HENRY III RAINBOLT (PA-C) across health systems?
The NPI 1134769367 uniquely identifies HENRY III RAINBOLT (PA-C) in U.S. healthcare data.
Does the public listing show HENRY III RAINBOLT (PA-C) as active?
HENRY III RAINBOLT (PA-C)'s NPI record reflects an active status in NPPES.
How should patients interpret HENRY III RAINBOLT (PA-C)'s specialty?
The extract shows Physician Assistant for HENRY III RAINBOLT (PA-C). Clinical services aligned with this taxonomy classification.
What city is tied to HENRY III RAINBOLT (PA-C)?
The directory associates HENRY III RAINBOLT (PA-C) with Columbia, Missouri. Check all listed addresses for suites or satellite offices.
Can I export HENRY III RAINBOLT (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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