CLARENCE RICHARD GRAVES III


Address: 509 Se Riverside Dr, Suite 203, Stuart, FL 34994-2579
Phone: 7722885862

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA9106480 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL FLORIDA BLUE Y0C06 01
FL 004802000 05

Office Location

Street Address 509 SE RIVERSIDE DR
SUITE 203
City STUART
State FL
Zip Code 34994-2579

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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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City STUART
Zip Code 34994

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Dataset Information

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.

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