Individual provider Active NPI

Paul Edward Raber, DO

  • Family Medicine Physician
  • Madison, GA
National Provider Identifier
1740394428
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042704 Issued in GA
Practice address
1550 Eatonton Rd
Madison, GA 30650-4627
Phone
(706) 752-0322
Fax
(978) 327-7921
NPI assigned
Aug 18, 2006
Last updated
May 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042704 GA Primary

Addresses

Primary practice location

1550 Eatonton Rd
Madison, GA 30650-4627

Mailing address

PO Box 209
Madison, GA 30650-0209
Phone (706) 752-0322

Other identifiers 1

IdentifierTypeStateIssuer
000739252KMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070201000218 GA Practitioner - Family Practice 0547262792 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
After Hours Urgent Care, LLCGroup PAC ID 6103160171, 2 clinicians
Madison Medical Associates, PCGroup PAC ID 7315033842, 2 clinicians

Practice addresses (Care Compare)

1550 Eatonton Rd
Madison, GA 30650-4627
Phone (706) 438-6486

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042704GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince Mar 1, 2021 Accepting new patients
Southland Taylor Hospitalist Group, LLC CurrentSince Mar 1, 2021 Accepting new patients
Southland Cochran Emergency Medical Services, LLC CurrentSince Mar 1, 2021 Accepting new patients
After Hours Urgent Care, LLC Family Medicine CurrentSince May 7, 2021 Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Apr 23, 2017 Accepting new patients

Locations

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-1072

1550 Eatonton Rd
Madison, GA 30650
Phone (706) 438-6486

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1740394428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306500209",
            "telephone_number": "706-752-0322",
            "fax_number": "978-327-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 EATONTON RD",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306504627",
            "telephone_number": "706-752-0322",
            "fax_number": "978-327-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABER",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "042704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000739252K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, GA

Sources for this page

Verify at the official NPI Registry.