Charles Duane Radebaugh, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1193T Issued in OR

Practice address

1800 Centennial Blvd
Suite 2
Springfield, OR 97477-4385

Phone

(541) 726-5055

NPI assigned

Nov 17, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710969480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 CENTENNIAL BLVD",
            "address_2": "SUITE 2",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774385",
            "telephone_number": "541-726-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CENTENNIAL BLVD",
            "address_2": "SUITE 2",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774385",
            "telephone_number": "541-726-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEBAUGH",
        "first_name": "CHARLES",
        "middle_name": "DUANE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1193T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167197",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Springfield, OR
• Providers in Springfield, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.