Samuel Dubose Ravenel, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

14283 Issued in NC

Practice address

1814 Westchester Drive
Suite 203
High Point, NC 27262-3832

Phone

(336) 802-2100

Fax

(336) 802-2101

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cornerstone Health Care PA

  • Cardiovascular Disease Physician
  • Statesville, NC
  • NPI 1275914046
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1447297635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 WESTCHESTER DRIVE",
            "address_2": "SUITE 203",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-802-2100",
            "fax_number": "336-802-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVENEL",
        "first_name": "SAMUEL",
        "middle_name": "DUBOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "14283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8970539",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erik G Rankins
• Jia Rao, DMD
• David Alan Rappaport, PHARMD.
• Mohammad Rasool, MD
• Zoaib Safdar Rasool, D.O
• Cleo Ready, BCBA
• Ree'S Residential Facility
• Graig Thomas Reed, PHARMD
• Reeder Gastroenterology PC
• Tracy Reese, RN

• Pediatrics Physician in High Point, NC
• Providers in High Point, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.