RAVEN LIONEL DELOATCH (NPI# 1740268598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740268598 |
| Entity Type | Individual |
| Full Name | RAVEN LIONEL DELOATCH |
| Credential | MD |
| Practice Address |
9425 Nc Highway 305 Jackson NC 27845-9679 |
| Mailing Address |
Po Box 640 Roanoke Rapids NC 27870-0640 |
| Practice Telephone | 2525341661 |
| Practice Fax Number | 2525342841 |
| Mailing Telephone | 2525365791 |
| Mailing Fax Number | 2525365444 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2015-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 31478 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | UNITED HEALTH CARE # | 0454365 | 01 |
| NC | MEDCOST LLC PROVIDER # | D2792 | 01 |
| NC | DEA CERTIFICATE # | BD1263045 | 01 |
| NC | RAILROAD MEDICARE # | 110147756 | 01 |
| NC | ANTHEM SERVICES PROVIDER# | 112536 | 01 |
| NC | MAMSI PROVIDER # | 289354 | 01 |
| NC | 7928324 | 05 | |
| NC | BLUE CROSS BLUE SHIELD # | 28324 | 01 |
| NC | NC MEDICAL LICENSE # | 31478 | 01 |
| Street Address |
9425 NC HIGHWAY 305 |
| City | JACKSON |
| State | NC |
| Zip Code | 27845-9679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114483674 | Sarah Beatrice Robinson | Speech-Language Pathologist | 200 Hampton Woods Road, Jackson, NC 27845 | 2019-02-20 |
| 1013244342 | Cnc/access Inc. | In Home Supportive Care | 9486 Nc Hwy 305, Jackson, NC 27845 | 2009-11-06 |
| 1699002923 | Cnc/access Inc | Community/Behavioral Health | 9486 Nc Highway 305, Jackson, NC 27845 | 2009-11-06 |
| 1013109552 | Terri Martin Revelle | Psychologist | 111 E. Jefferson St., Jackson, NC 27845 | 2007-08-17 |
| 1881890424 | Northampton County Dss | Public Health or Welfare | 9467 Nc 305 Hwy., Jackson, NC 27845 | 2007-06-21 |
| 1588868400 | Northampton County | Ambulance | 132 Landfeild Road, Jackson, NC 27845 | 2007-06-13 |
| 1689626178 | Rural Health Group, Inc. | Clinic/Center | 9425 Nc 305 Hwy, Jackson, NC 27845 | 2006-05-16 |
| 1538687132 | Shatoya Ronique Joyner | Social Worker | 9486 Nc Highway 305, Jackson, NC 27845 | 2017-09-03 |
| 1760707996 | Integrated Family Services, Pllc | Social Worker | 9486 Nc Hwy 305, Jackson, NC 27845 | 2010-03-31 |
| 1659538825 | Megan Kathleen Farrelly | Dentist | 9409 Nc Hwy 305, Jackson, NC 27845 | 2008-05-16 |
| Find all providers in zip 27845 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215556048 | Hannah Roberts Badon | Internal Medicine | 2450 Wild Valley Dr, Jackson, MS 39211-6224 | 2020-04-12 |
| 1649809476 | Rachel Horn Mullins | Internal Medicine | 5379 Fairway St, Jackson, MS 39211-4251 | 2020-04-03 |
| 1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
| 1356605752 | Jeremy Taylor | Internal Medicine | 971 Lakeland Dr Ste 450, Jackson, MS 39216-4615 | 2012-06-29 |
| 1134416019 | Zubair Khan | Internal Medicine | 3291 Creekwood Cir, Jackson, WI 53037-8927 | 2011-06-29 |
| 1801181466 | Anne Marie Shute | Internal Medicine | 7 Windwood Dr, Jackson, TN 38305-8835 | 2011-06-12 |
| 1487945648 | Howard Carroll Friday | Internal Medicine | 4019 Old Canton Rd., Jackson, MS 39216 | 2011-04-22 |
| 1801195003 | Mahir H Alsalman | Internal Medicine | 3100 Cooper St, Jackson, MI 49201-7545 | 2011-03-28 |
| 1912138967 | Tatum Medical Clinic | Internal Medicine | 5903 Ridgewood Rd Ste 330, Jackson, MS 39211-3702 | 2009-08-06 |
| 1306089040 | Hussein Othman | Internal Medicine | 205 Page Ave Ste B, Jackson, MI 49201-2462 | 2009-04-10 |
| Find all providers in JACKSON | ||||
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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.