SAMUEL K ST CLAIR (NPI# 1073588000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073588000 |
| Entity Type | Individual |
| Full Name | SAMUEL K ST CLAIR |
| Credential | MD |
| Practice Address |
4207 Lake Boone Trl Ste 220 Raleigh NC 27607-6685 |
| Mailing Address |
4201 Lake Boone Trl Ste 202 Raleigh NC 27607-7512 |
| Practice Telephone | 9197841410 |
| Mailing Telephone | 9192350500 |
| Mailing Fax Number | 9192350505 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2019-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 39097 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | CHOICE CARE NETWORK | 706943 | 01 |
| NC | RAILROAD MEDICARE | 140006908 | 01 |
| NC | 8979535 | 05 | |
| NC | AETNA | 4063806 | 01 |
| NC | MEDCOST | 97486 | 01 |
| NC | FIRST HEALTH | 2070150 | 01 |
| NC | BCBS NC | 79535 | 01 |
| NC | UNITED HEALTHCARE | 0650385 | 01 |
| NC | TRICARE | 56219447701 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4201 Lake Boone Trl, Ste 202, Raleigh, NC 276077512 | 9192350500 | 9192350505 |
| Street Address |
4207 LAKE BOONE TRL STE 220 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932174372 | Robin Frederick Koeleveld | Neurological Surgery | 4207 Lake Boone Trl Ste 220, Raleigh, NC 27607-6685 | 2006-02-21 |
| 1922573823 | Allyssa Blaire Newton | Nurse Practitioner | 4207 Lake Boone Trl Ste 220, Raleigh, NC 27607-6685 | 2018-10-06 |
| 1699925537 | Jessica Gray Brock | Physician Assistant | 4207 Lake Boone Trl Ste 220, Raleigh, NC 27607-6685 | 2008-09-29 |
| 1750587036 | John A Engler | Neurological Surgery | 4207 Lake Boone Trl Ste 220, Raleigh, NC 27607-6685 | 2007-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538616289 | Private Diagnostic Clinic, Pllc | Neurological Surgery | 1212 Cedarhurst Dr Ste 102, Raleigh, NC 27609-5588 | 2016-09-09 |
| 1598702490 | Raleigh Neurosurgical Clinic, Inc. | Neurological Surgery | 5838 Six Forks Road, Suite 100, Raleigh, NC 27609 | 2006-05-31 |
| 1932174372 | Robin Frederick Koeleveld | Neurological Surgery | 4207 Lake Boone Trl Ste 220, Raleigh, NC 27607-6685 | 2006-02-21 |
| 1447225040 | Kimberly Livingston | Neurological Surgery | 5838 Six Forks Rd Ste 100, Raleigh, NC 27609-3893 | 2006-02-17 |
| 1477523082 | Robert Lacin | Neurological Surgery | 5838 Six Forks Rd, Suite 100, Raleigh, NC 27609-3885 | 2006-01-25 |
| 1760489967 | Kenneth John Rich | Neurological Surgery | 1100 Dresser Court, Suite 100, Raleigh, NC 27609 | 2005-07-01 |
| 1982247292 | Coral Elyse Stevens Hodges | Neurological Surgery | 3400 Wake Forest Rd, Raleigh, NC 27609-7317 | 2019-10-21 |
| 1659700144 | Rex Hospital Inc | Neurological Surgery | 4207 Lake Boone Trl, Suite 220, Raleigh, NC 27607-6684 | 2013-11-05 |
| 1134464597 | Rex Physicians LLC | Neurological Surgery | 4207 Lake Boone Trl, Suite 220, Raleigh, NC 27607-6684 | 2012-12-11 |
| 1477862969 | Lars Benjamin Gardner | Neurological Surgery | 5838 Six Forks Rd, Suite 100, Raleigh, NC 27609-3885 | 2010-09-30 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.