Carie Ann Radabaugh, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

10057-16 Issued in WI

Practice address

1313 Fairgrounds Rd
Two Harbors, MN 55616-4600

Phone

(218) 206-4328

NPI assigned

Oct 5, 2012

Last updated

Oct 5, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1912259557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7955 E MINNESUING ACRES DR",
            "city": "LAKE NEBAGAMON",
            "state": "WI",
            "postal_code": "548499067",
            "telephone_number": "715-374-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FAIRGROUNDS RD",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556164600",
            "telephone_number": "218-206-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADABAUGH",
        "first_name": "CARIE",
        "middle_name": "ANN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "10057-16",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H7750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Andrew Peterson, M.D.
• Amy Lynn Phipps-Poe, P.T.
• Heather Pipes, LPMA
• Premise Health of Minnesota Medical P C (LP Health Center-Two Harbors)
• Adriana Quadhamer
• John Byron Radzak
• Kathleen Faye Ray, RN
• Shana Lea Roberts, MSW, LICSW
• Susan Marie Rosette
• Kelsey May Schultz, M.D.

• Dental Hygienist in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Dental Hygienist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.