Active NPI
Raymond P Cloutier, MD
- Internal Medicine Physician
- Evansville, IN
National Provider Identifier
1730299942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 16217
- Practice address
- 500 E Walnut St
Evansville, IN 47713-2438 - Phone
- (812) 465-6288
- NPI assigned
- Aug 30, 2006
- Last updated
- Jul 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16217 | KY | Primary |
Addresses
Primary practice location
500 E Walnut St
Evansville, IN 47713-2438
Mailing address
577 Drakesborough Dr
Bowling Green, KY 42103-9748
Phone (270) 781-7321
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64162175 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150317000293 | KY | Order and Referring Only - Internal Medicine | 6305027384 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16217 | KY | MD | Internal Medicine Physician |
| 16219 | KY | MD | Ophthalmology Physician |
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": "1184025600000",
"number": "1730299942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "577 DRAKESBOROUGH DR",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421039748",
"telephone_number": "270-781-7321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E WALNUT ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477132438",
"telephone_number": "812-465-6288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUTIER",
"first_name": "RAYMOND",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "16217",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64162175",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.