DR. CHARLES WILLIAM RAUDAT (NPI# 1043263783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043263783 |
| Entity Type | Individual |
| Full Name | DR. CHARLES WILLIAM RAUDAT |
| Credential | D.O. |
| Practice Address |
310 N State of Franklin Rd Suite 101 Johnson City TN 37604-6008 |
| Practice Telephone | 4239297393 |
| Practice Fax Number | 4239290872 |
| Mailing Telephone | 4239297393 |
| Mailing Fax Number | 4239290872 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2017-02-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2525 | TN | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 238582 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1043263783 | 05 | |
| TN | RAILROAD MEDICARE | P01227008 | 01 |
| TN | Q001730 | 05 | |
| NY | 02738241 | 05 |
| Street Address |
310 N STATE OF FRANKLIN RD SUITE 101 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598769903 | Pamela L. Greer | Nurse Practitioner | 310 N State of Franklin Rd, Ste 202, Johnson City, TN 37604-6063 | 2005-06-13 |
| 1659817377 | Shandon Morrison | Nurse Practitioner | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2017-01-19 |
| 1366990442 | Michelle L Jones | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2016-09-16 |
| 1881147692 | Deretsa Perry | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2016-07-28 |
| 1053762112 | Blue Ridge Medical Management Corporation | Internal Medicine | 310 N State of Franklin Rd, Ste 301a, Johnson City, TN 37604-6008 | 2016-06-29 |
| 1669864377 | Emily Kathleen Price | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2015-03-04 |
| 1366862336 | Miranda Kyker | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2014-04-17 |
| 1114340445 | Blue Ridge Medical Management | Surgery | 310 N State of Franklin Rd, Suite 101b, Johnson City, TN 37604-6008 | 2014-01-22 |
| 1225389349 | Trinity Cancer Care, P.C. | Internal Medicine | 310 N State of Franklin Rd, Suite 401, Johnson City, TN 37604-6073 | 2012-09-28 |
| 1285936930 | Ryan Kara Judson | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2010-12-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164793774 | Richard A Feit | Thoracic Surgery (Cardiothoracic Vascular Surgery) | East Tennessee State University Quillen College, Of Medicine Department of Academic Affairs, Johnson City, TN 37614-1708 | 2012-01-13 |
| 1376833210 | David Alan Baker | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 912 Millercrest Dr, Johnson City, TN 37604-4315 | 2011-04-12 |
| 1912078254 | Kevin Casey | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 310 N State of Franklin Rd, Suite 101, Johnson City, TN 37604-6008 | 2006-11-10 |
| 1801806062 | Binghamton Cardiovascular & Thoracic Surgeons, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 41 Arch St, Johnson City, NY 13790-2101 | 2006-08-09 |
| 1366479453 | Kenneth Ting-hung Wong | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 Harrison St Ste 250, Johnson City, NY 13790-2176 | 2006-06-26 |
| 1629030267 | Anthony J Palazzo | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 310 N State of Franklin Rd, Suite 101, Johnson City, TN 37604-6008 | 2006-04-06 |
| 1427045996 | D Glenn Pennington | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 325 N State of Franklin Rd, Johnson City, TN 37604-6062 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073855888 | Walter Howard Brott | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3701 Maloney Rd, Knoxville, TN 37920-2821 | 2013-03-19 |
| 1023358793 | David H Sewell | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1723 Orchard Pl, Kingsport, TN 37660-4523 | 2013-02-18 |
| 1962769216 | Robert Edwin Ware | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3548 Captains Way, Knoxville, TN 37922-9420 | 2012-04-11 |
| 1720359862 | Hiroshi Toyohara | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 210 Crestridge Rd, Knoxville, TN 37919-5920 | 2012-01-20 |
| 1811146988 | Denis Michael Gilmore | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2400 Patterson St Ste 215, Nashville, TN 37203 | 2008-09-15 |
| 1811145584 | Joel Eugene Avery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15 Hidden Brook Lane, Signal Mtn, TN 37377 | 2008-09-05 |
| 1053578518 | Jeffrey Aaron Poynter | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 979 E 3rd St Ste C-520, Chattanooga, TN 37403 | 2008-05-21 |
| 1063698637 | Davis C. Drinkwater, Md, Plc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4390 Chickering Ln, Nashville, TN 37215-4920 | 2008-01-14 |
| 1629257043 | Fontaine S Hill Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 16 Colonel Winstead Dr, Brentwood, TN 37027-8936 | 2007-11-01 |
| 1174713457 | S. Salman Ahmad Shah | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 101 Gillespie Dr Apt 11207, Franklin, TN 37067-7550 | 2007-08-01 |
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| City | JOHNSON CITY |
| Zip Code | 37604 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.