Vance Andre' Raham, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

01045645A Issued in IN

Practice address

335 Roselane St NW Ste 203
Marietta, GA 30060-7902

Phone

(678) 882-0878

Fax

(678) 224-8183

NPI assigned

Feb 8, 2006

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

Enrolled in IN

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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 Medicine

State licenses

Practice roles

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

• Luke Medical Transport LLC

  • Land Ambulance
  • Dallas, GA
  • NPI 1295376838
  NPD Authorized official
• Acorn Addiction Centers LLC Dba Journey Road Treatment Centers

  • Addiction Medicine (Family Medicine) Physician
  • Indianapolis, IN
  • NPI 1467824698
  Medicare reassignment
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1881667046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 ROSELANE ST NW STE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607902",
            "telephone_number": "678-882-0878",
            "fax_number": "678-224-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 ROSELANE ST NW STE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607902",
            "telephone_number": "678-882-0878",
            "fax_number": "678-224-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHAM",
        "first_name": "VANCE",
        "middle_name": "ANDRE'",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01045645A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01045645A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200111860A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Radiology Atlanta Group
• Radiology Centers of Georgia, LLC
• Robin Raflo, LCSW
• Carson Cooke Ragan, CNM
• Jeremy Thomas Ragland, MD
• Roma Raheja, LCSW
• Rahman Dentistry,LLC
• Aamer Rahman, M.D
• Ayesha Rahman, D.M.D.
• Aaron Michael Rahn, O.D.

• Addiction Medicine (Family Medicine) Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Addiction Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.

Verify at the official NPI Registry.