Lee Graham Raudenbush, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001-01241 Issued in NC

Practice address

3425 Melrose Rd
Behavioral Health Care
Fayetteville, NC 28304-1608

Phone

(910) 615-3738

Fax

(910) 609-3784

NPI assigned

Mar 23, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1811957111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5804 HIBERNIA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141302",
            "telephone_number": "910-488-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 MELROSE RD",
            "address_2": "BEHAVIORAL HEALTH CARE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041608",
            "telephone_number": "910-615-3738",
            "fax_number": "910-609-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUDENBUSH",
        "first_name": "LEE",
        "middle_name": "GRAHAM",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001-01241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Carol Rastelli, NP-C
• Forest Rathfon
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• Abrar Raviv, DO
• Anuva Ray

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.