ROBERT J GAUDET (NPI# 1518908169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518908169 |
| Entity Type | Individual |
| Full Name | ROBERT J GAUDET |
| Credential | MD |
| Practice Address |
1773 Rose Ridge Clintwood VA 24228 |
| Mailing Address |
Po Box 1980 Clintwood VA 24228-1980 |
| Practice Telephone | 2762180032 |
| Practice Fax Number | 2762769260 |
| Mailing Telephone | 2762180032 |
| Mailing Fax Number | 2762769260 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-08-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 0101036758 | VA | Allopathic & Osteopathic Physicians |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0101367586 | VA | Allopathic & Osteopathic Physicians |
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
D35461 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1518908169 | 05 | |
| VA | 5600378000 | 05 | |
| MD | 549841400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063706331 | Robert Edward Gaudet Jr. | Internal Medicine | 55 Lake Ave N, Worcester, MA 01655-0002 | 2011-06-04 |
| Street Address |
1773 ROSE RIDGE |
| City | CLINTWOOD |
| State | VA |
| Zip Code | 24228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851816953 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5451 Dickenson Hwy, Clintwood, VA 24228 | 2017-08-09 |
| 1669902243 | Mountain States Health Alliance | Hospice Care, Community Based | 312 Hospital Dr Suite 1b, Clintwood, VA 24228 | 2017-06-15 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1134667009 | Amy Meade | Pharmacist | 342 Main Street, Clintwood, VA 24228 | 2017-02-10 |
| 1881087385 | Family Preservation Services, Inc | Community/Behavioral Health | 1381 Rose Ridge Ct, Clintwood, VA 24228 | 2015-03-09 |
| 1477951515 | Tauna Gulley | Nurse Practitioner | 233 Chase Street, Suite 100, Clintwood, VA 24228 | 2014-12-05 |
| 1740696152 | Family Preservation Services, Inc. | Community/Behavioral Health | 5123 Dickenson Highway, Clintwood, VA 24228 | 2014-07-07 |
| 1962816884 | Family Preservation Services, Inc | Community/Behavioral Health | 5123 & 5127 Dickenson Highway, Clintwood, VA 24228 | 2014-06-18 |
| 1003163643 | Family Preservation Services, Inc | Community/Behavioral Health | 150 Elementary Circle, Clintwood, VA 24228 | 2012-08-14 |
| 1265739122 | Family Preservation Services, Inc. | Community/Behavioral Health | Technology Park Drive, Clintwood, VA 24228 | 2011-02-11 |
| Find all providers in zip 24228 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114545928 | Raven Matthews | Emergency Medicine | 213 18th St Se, Roanoke, VA 24013-1311 | 2020-07-08 |
| 1285257915 | Timothy Horner | Emergency Medicine | 3900 Lee Hwy, Arlington, VA 22207-3724 | 2020-05-28 |
| 1548890304 | Enoch Agyemang | Emergency Medicine | 146 Short Branch Rd, Stafford, VA 22556-4642 | 2020-01-21 |
| 1073800710 | Moses Tucker Laffitte Iv | Emergency Medicine | 800 Gresham Drive, Norfolk, VA 23507 | 2011-07-01 |
| 1629139969 | Eugene Francis Delaune IIi | Emergency Medicine | 7804 Accotink Pl, Alexandria, VA 22308-1226 | 2006-12-12 |
| 1225103567 | Daniel T Threat Jr. | Emergency Medicine | 4619 Gregorys Charter Ct, Richmond, VA 23236-1062 | 2006-11-21 |
| 1801814678 | Scott Alan Wright | Emergency Medicine | 961 E Stuart Dr, Galax, VA 24333-2407 | 2006-07-18 |
| 1124055777 | James L Brewer IIi | Emergency Medicine | One Arh Ln, Low Moor, VA 24457 | 2006-06-27 |
| 1073593885 | Yusuf Hameed Khan | Emergency Medicine | 11484 Washington Paza W, Suite #300, Reston, VA 20190 | 2006-01-18 |
| 1174143580 | Calvin Nguyen | Emergency Medicine | 12099 Government Center Pkwy, Fairfax, VA 22035-5501 | 2020-04-26 |
| Find all providers with the same taxonomy | ||||
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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.