CHARLES BERNARD CLAGETT JR. (NPI# 1467421545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467421545 |
| Entity Type | Individual |
| Full Name | CHARLES BERNARD CLAGETT JR. |
| Credential | MD |
| Practice Address |
2111 Lexington Ave Lawrenceville IL 62439-2085 |
| Practice Telephone | 6189431000 |
| Mailing Telephone | 6189431000 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2016-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036130039 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | MD2011-0635 | NM | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | ME75440 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036130039 | 05 | |
| FL | 254190400 | 05 | |
| FL | MEDICARE ID/RRM PIN | 110169444 | 01 |
| Street Address |
2111 LEXINGTON AVE |
| City | LAWRENCEVILLE |
| State | IL |
| Zip Code | 62439-2085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902884273 | Rachel Ann Winters | Family Medicine | 2111 Lexington Ave, Lawrenceville, IL 62439-2085 | 2006-01-05 |
| 1073003588 | Michelle Macey Thacker | Nurse Practitioner | 2111 Lexington Ave, Lawrenceville, IL 62439 | 2018-05-10 |
| 1164952073 | Tracy R Ramsey | Nurse Practitioner | 2111 Lexington Ave, Lawrenceville, IL 62439-2085 | 2017-06-13 |
| 1720529001 | Rachel A. Winters M.d. | Family Medicine | 2111 Lexington Ave, Suite 3, Lawrenceville, IL 62439-2085 | 2017-03-20 |
| 1942668314 | Kathleen E Clark | Nurse Practitioner | 2111 Lexington Ave, Ste #1, Lawrenceville, IL 62439 | 2016-02-01 |
| 1740456573 | Steven M. Ramsaran, Md | Clinic/Center | 2111 Lexington Ave, Suite 6, Lawrenceville, IL 62439-2085 | 2008-05-01 |
| 1811183692 | Lawrence County Memorial Hospital | Clinic/Center | 2111 Lexington Ave, Lawrenceville, IL 62439-2085 | 2007-09-14 |
| 1346449188 | Tanna Lynn Mccullough | Nurse Practitioner | 2111 Lexington Ave, Lawrenceville, IL 62439-2085 | 2007-07-12 |
| 1932308749 | Lawrence County Rule Health Clinic | Clinic/Center | 2111 Lexington Ave, Lawrenceville, IL 62439-2085 | 2007-07-12 |
| 1538134416 | Steven Mark Ramsaran | Family Medicine | 2111 Lexington Ave, Suite 6, Lawrenceville, IL 62439-2085 | 2006-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406590 | Allyson Fiscus | Nurse Practitioner | 11020 Il-250, Lawrenceville, IL 62439 | 2020-08-06 |
| 1164071700 | Lauren E Welton | Case Manager/Care Coordinator | 11362 Country Club Road, Lawrenceville, IL 62439 | 2019-09-06 |
| 1962063354 | Connie Deckard | Counselor | Lawrence County Health Department Behavior Health, 11020 State Route 250, Lawrenceville, IL 62439 | 2019-06-26 |
| 1225485527 | Megan Joergens | Social Worker | 11120 State Route 250, Lawrenceville, IL 62439 | 2016-05-17 |
| 1235509456 | Christy M Wimberly | Private Vehicle | 1417 Dubios St., Lawrenceville, IL 62439 | 2015-09-30 |
| 1144637521 | Joy Singson Uy | Physical Therapist | 2101 James St United Methodist Village North, Lawrenceville, IL 62439 | 2014-07-17 |
| 1760791792 | Lawrence Co | Secured Medical Transport (VAN) | 2009 Lexington Ave, Lawrenceville, IL 62439 | 2010-09-24 |
| 1134358922 | Lawrence County Health Department | Public Health or Welfare | Rural Route3 Box 430, Lawrenceville, IL 62439 | 2009-07-14 |
| 1366678161 | Judith Joan Phipps | Counselor | Rr1 Box 277, Lawrenceville, IL 62439 | 2009-06-08 |
| 1366648784 | S. Hurn Baek | Radiology | Lawrence County Memorial Hospital, Radiology, 2200 W. State St., Lawrenceville, IL 62439 | 2007-06-22 |
| Find all providers in zip 62439 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669989422 | Choicemed Inc | Family Medicine | 3545 Cruse Rd Ste 100, Lawrenceville, GA 30044-3169 | 2018-01-02 |
| 1356705768 | Mark Adam Theodore Molckovsky | Family Medicine | 32 East Lawrence Road, Lawrenceville, PA 16929 | 2016-04-12 |
| 1902290570 | New League Family Practice | Family Medicine | 428 Waterbury Dr, Lawrenceville, GA 30046-3323 | 2015-03-23 |
| 1114347580 | Tik Pau | Family Medicine | 665 Duluth Hwy Ste 501, Lawrenceville, GA 30046-8709 | 2014-04-23 |
| 1346687696 | Paul Andrew Robertson | Family Medicine | 825 Meadowsong Cir, Lawrenceville, GA 30043-4236 | 2013-05-28 |
| 1952667388 | Alfred B. Amendolara Md, PC | Family Medicine | 2380 Lawrenceville Rd, Lawrenceville, NJ 08648 | 2012-04-10 |
| 1013200096 | Sana Rabbi | Family Medicine | 455 Philip Blvd, Ste 130, Kaiser Permanente Lawrenceville Medical Office, Lawrenceville, GA 30046 | 2011-05-24 |
| 1992021232 | Community Family Practice and Urgent Care P C | Family Medicine | 277 E Crogan St, Lawrenceville, GA 30046-5054 | 2010-04-12 |
| 1013148626 | Sheila Kennedy | Family Medicine | 1430 Five Forks Trickum Rd St 220, Lawrenceville, GA 30044-8182 | 2009-07-30 |
| 1366628117 | Nazra Baluch | Family Medicine | 1692 Atkinson Park Cir, Lawrenceville, GA 30043-7937 | 2008-01-10 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 62439 |
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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.