Kathleen M Raviele, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

020801 Issued in GA

Practice address

2799 Lawrenceville Hwy
Suite 110
Decatur, GA 30033-2517

Phone

(770) 491-0255

Fax

(770) 491-8157

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1508954298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 LAWRENCEVILLE HWY",
            "address_2": "SUITE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332517",
            "telephone_number": "770-491-0255",
            "fax_number": "770-491-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 LAWRENCEVILLE HWY",
            "address_2": "SUITE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332517",
            "telephone_number": "770-491-0255",
            "fax_number": "770-491-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIELE",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "020801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000179935C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PALMETT",
            "identifier": "160056472",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7406947",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "16BDCCB",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra D Rasouliyan, L.P.C.
• Rashanna Ratliff, LPC
• Caitlin Virginia Rattigan, MSW, LCSW
• Joan Rau
• David B Rausher, M.D.
• Karen R Rawle, LCSW
• Larry Graydon Ray Jr., MD
• Stephanie M Ray, LPC
• Jacob Raymond
• RC Cancer Centers - Decatur

• Gynecology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.