CHARLES DUANE RADEBAUGH (NPI# 1710969480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710969480 |
| Entity Type | Individual |
| Full Name | CHARLES DUANE RADEBAUGH |
| Credential | O.D. |
| Practice Address |
1800 Centennial Blvd Suite 2 Springfield OR 97477-4385 |
| Practice Telephone | 5417265055 |
| Mailing Telephone | 5417265055 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 3463 | WA | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 1193T | OR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 167197 | 05 |
| Street Address |
1800 CENTENNIAL BLVD SUITE 2 |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97477-4385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932609245 | Nicole Kepner | Pharmacist | 1800 Centennial Blvd, Springfield, OR 97477 | 2018-02-14 |
| 1114396199 | Springfield Family Physicians | Family Medicine | 1800 Centennial Blvd, Springfield, OR 97477-4385 | 2015-09-18 |
| 1265847271 | Julie Kay Mott | Counselor | 1800 Centennial Blvd, Springfield, OR 97477 | 2014-06-27 |
| 1801174305 | Jenae Ulrich | Psychologist | 1800 Centennial Blvd, Springfield, OR 97477-4385 | 2011-08-01 |
| 1508190661 | Ppc Group LLC | Clinic/Center | 1800 Centennial Blvd, Suite #6, Springfield, OR 97477-4385 | 2009-09-22 |
| 1760434385 | Alison Joan Erde | Family Medicine | 1800 Centennial Blvd, 6, Springfield, OR 97477-4385 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
| 1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
| 1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
| 1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
| 1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
| 1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
| Find all providers in zip 97477 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938092 | Premier Vision Center LLC | Optometrist | 2809 Mansion Rd Ste A, Springfield, IL 62711-6811 | 2020-06-25 |
| 1376180109 | Drs. Akre & Clark, Ltd. | Optometrist | 623 W Rock St, Springfield, MN 56087-1028 | 2019-11-27 |
| 1407410087 | Missouri Physicians Eyecare Group, P.C. | Optometrist | 1415 E Battlefield St, Springfield, MO 65804-3701 | 2019-04-29 |
| 1467931006 | Vision Care Focus, LLC | Optometrist | 1507 Mohawk Blvd, Springfield, OR 97477-3355 | 2018-08-13 |
| 1306337126 | Casey Marie Smith | Optometrist | 1024 N Plum St, Springfield, OH 45504-2108 | 2018-05-29 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1790299311 | Springfield Eye Specialists LLC | Optometrist | 3231 S National Ave Ste 165, Springfield, MO 65807-7304 | 2017-11-17 |
| 1093253247 | Minh-tam Nguyen | Optometrist | 8424 Old Keene Mill Rd, Springfield, VA 22152-2302 | 2017-02-08 |
| 1013453877 | Grace Chang, Od PC | Optometrist | 6575n Frontier Dr, Springfield, VA 22150-1415 | 2017-01-17 |
| 1669821914 | Laura Kay | Optometrist | 1342 E Primrose St Ste B, Springfield, MO 65804-4224 | 2016-06-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97477 |
Please comment or provide details below to improve the information on CHARLES DUANE RADEBAUGH.
| 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.