Individual provider Active NPI

Raphael A. Carter, M.D.

  • Family Medicine Physician
  • Seymour, IN
National Provider Identifier
1043320583
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01044045A Issued in IN
Practice address
7830 Persimmon Lake Dr
Seymour, IN 47274-7926
Phone
(812) 497-0660
Fax
(812) 358-2446
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01044045A IN Primary
Emergency Medicine Physician 207P00000X 01044045A IN

Addresses

Primary practice location

7830 Persimmon Lake Dr
Seymour, IN 47274-7926

Mailing address

7830 Persimmon Lake Dr
Seymour, IN 47274-7926
Phone (812) 497-0660

Other identifiers 1

IdentifierTypeStateIssuer
200061980AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000192 IN Practitioner - Emergency MedicinePractitioner - Family Practice 4789717992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
University of Kentucky College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians of Memphis LLC 92 clinicians

Practice addresses (Care Compare)

1451 N Gardner St
Scottsburg, IN 47170-7751
Phone (812) 752-3456

Hospital & facility affiliations

  • Norton Scott Hospital Hospital, Scottsburg, IN, CCN 151334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01044045AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Apr 1, 2013 Accepting new patients
Hospital Medicine Services of Tennessee PC Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Brownstown Family Medicine,PC Family Medicine PastSince Aug 1, 1997 Accepting new patients

Locations

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1043320583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 PERSIMMON LAKE DR",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472747926",
            "telephone_number": "812-497-0660",
            "fax_number": "812-358-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 PERSIMMON LAKE DR",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472747926",
            "telephone_number": "812-497-0660",
            "fax_number": "812-358-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "RAPHAEL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01044045A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01044045A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200061980A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.