CLARENCE RICHARD GRAVES III (NPI# 1568468437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568468437 |
Entity Type | Individual |
Full Name | CLARENCE RICHARD GRAVES III |
Credential | PA-C |
Practice Address |
509 Se Riverside Dr Suite 203 Stuart FL 34994-2579 |
Mailing Address |
Po Box 417 Stuart FL 34995-0417 |
Practice Telephone | 7722885862 |
Practice Fax Number | 7722885874 |
Mailing Telephone | 7722232832 |
Mailing Fax Number | 7722235646 |
Enumeration Date | 2005-06-24 |
Last Update Date | 2020-10-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | PA9106480 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | FLORIDA BLUE | Y0C06 | 01 |
FL | 004802000 | 05 |
Street Address |
509 SE RIVERSIDE DR SUITE 203 |
City | STUART |
State | FL |
Zip Code | 34994-2579 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841632304 | Mary Elizabeth Callahan | Physician Assistant | 509 Se Riverside Dr, Ste 300, Stuart, FL 34994-2579 | 2013-07-25 |
1083977805 | Brian B Foster | Physician Assistant | 509 Se Riverside Dr, Suite 203, Stuart, FL 34994-2579 | 2012-06-18 |
1235410549 | Avron H Lipschitz Md Plastic Surgery LLC | Plastic Surgery | 509 Se Riverside Dr, Suite 301, Stuart, FL 34994-2579 | 2011-08-31 |
1679888945 | Kenneth L. Holling Md Pa | Internal Medicine | 509 Se Riverside Dr, Suite 200, Stuart, FL 34994-2579 | 2010-08-11 |
1942513114 | Sylvia Gates | Physician Assistant | 509 Se Riverside Dr, Ste 305, Stuart, FL 34994-2579 | 2010-07-16 |
1497083042 | Tiffany L Brown | Physician Assistant | 509 Se Riverside Dr, Ste 203, Stuart, FL 34994-2579 | 2009-11-19 |
1437314598 | Kevin Todd Claudeanos | Surgery | 509 Se Riverside Dr, Suite 305, Stuart, FL 34994-2579 | 2008-07-28 |
1568659902 | Pediatrics Care of Stuart,pa | Clinic/Center | 509 Se Riverside Dr, Suite#300, Stuart, FL 34994-2579 | 2007-10-01 |
1396944831 | Richard Russell Teed Jr. | Surgery | 509 Se Riverside Dr, Ste 305, Stuart, FL 34994-2579 | 2007-07-14 |
1285771543 | Oszkar Szentirmai | Neurological Surgery | 509 Se Riverside Dr, Suite 203, Stuart, FL 34994-2579 | 2007-01-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912543711 | Prestige Medical Billing. Inc | Durable Medical Equipment & Medical Supplies | 2678 Se Willoughby Blvd, Stuart, FL 34994 | 2019-11-27 |
1780229203 | Katherine Ginn | Occupational Therapist | 809 Se Central Parkway, Stuart, FL 34994 | 2019-11-07 |
1972167294 | Melissa Callaham Lcsw | Social Worker | 900 East Ocean Blvd., Suite D-130, Office 26, Stuart, FL 34994 | 2019-04-23 |
1053881300 | Spencer Perna | Chiropractor | 632 Se Monterey Rd., Stuart, FL 34994 | 2018-11-29 |
1720563521 | National Vision Inc | Technician/Technologist | 2600 Southeast Federal Highway, Stuart, FL 34994 | 2018-09-27 |
1649767351 | Frank Alario Md & Associates | Non-Pharmacy Dispensing Site | 721 South Colorado Avenue, Stuart, FL 34994 | 2018-04-18 |
1609305499 | Wideline Thelemaque-claire | Behavior Technician | 900 E Ocean Blvd, Suite 130d, Stuart, FL 34994 | 2017-06-06 |
1316488984 | Jessica Gaffney | Social Worker | 416 Se Balboa Ave., Suite 200, Stuart, FL 34994 | 2017-03-16 |
1578012035 | Essentials Medical Group, LLC | Internal Medicine | 2694 Se Willoughby Blvd, Stuart, FL 34994 | 2016-09-26 |
1356898324 | Waters Edge Dermatology Global LLC | Surgery | 2601 S Kanner Highway, Stuart, FL 34994 | 2016-09-07 |
Find all providers in zip 34994 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013529023 | Brittany Baumgartner | Physician Assistant | 1050 Se Monterey Rd Ste 201, Stuart, FL 34994-4512 | 2020-08-20 |
1831737352 | Allyson Miller | Physician Assistant | 3801 S Kanner Hwy Fl 2, Stuart, FL 34994-4801 | 2019-12-16 |
1225691405 | Stacy Willett | Physician Assistant | 516 Se Mill Stream Ter, Stuart, FL 34997-6376 | 2019-04-15 |
1366904138 | Bonnie Chappell | Physician Assistant | 4596 Se Beckett Ave, Stuart, FL 34997-5734 | 2019-04-02 |
1336653740 | Colton Keener | Physician Assistant | 1050 Se Monterey Rd Ste 302, Stuart, FL 34994-4512 | 2017-11-21 |
1013126853 | Katrina L Lelli | Physician Assistant | 2398 Se Ocean Blvd, Stuart, FL 34996-3310 | 2007-05-21 |
1013967223 | Jeanne M Laible | Physician Assistant | 110 W 2nd St, Stuart, NE 68780-0110 | 2006-05-10 |
1821046376 | Thomas W Ulrich | Physician Assistant | 884 Sw Bromelia Ter, Stuart, FL 34997-7144 | 2006-05-05 |
1871590562 | Kimberly Dillon Compton | Physician Assistant | 18877 Jeb Stuart Highway, Highway 58, Stuart, VA 24171-1019 | 2005-07-07 |
1194720797 | Caitlyn G Prucinsky | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2005-06-20 |
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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.