SHYAM SAMPATH RAGHAVAN (NPI# 1124394572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124394572 |
| Entity Type | Individual |
| Full Name | SHYAM SAMPATH RAGHAVAN |
| Credential | M.D. |
| Practice Address |
1215 Lee St Charlottesville VA 22908-2205 |
| Mailing Address |
Po Box 9007 Charlottesville VA 22906-9007 |
| Practice Telephone | 8888823990 |
| Practice Fax Number | 4342436499 |
| Mailing Telephone | 4342951000 |
| Mailing Fax Number | 4349724266 |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2020-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
101269055 | VA | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
101269055 | VA | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | A127813 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1215 LEE ST |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22908-2205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486328 | Kirk W Tanner | Nurse Anesthetist, Certified Registered | 1215 Lee St, Charlottesville, VA 22908-0816 | 2005-06-10 |
| 1801493283 | Angela Jewell Strickler | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-10-08 |
| 1629675475 | Kimberlee M Mauck | Physician Assistant | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-10-05 |
| 1407463953 | Amy Johnston | Clinical Nurse Specialist | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-29 |
| 1194332882 | Mihwa Ahn | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-26 |
| 1346856721 | Farren Hume Dodson | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-21 |
| 1003422619 | Darlene Acero | Dietitian, Registered | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-18 |
| 1689289571 | Erin Harr | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-09 |
| 1518572460 | Juan Pablo Sardi Restrepo | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Mail Stop 800212, Charlottesville, VA 22908-0816 | 2020-09-08 |
| 1366055956 | Erin Louise Tennyson | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020410 | Alexis Evans | Physician Assistant | 1215 Lee St Nnicu, Charlottesville, VA 22908 | 2019-06-04 |
| 1649702317 | Ryan Aschenbrener | Student in an Organized Health Care Education/Training Program | 545 Ray C Hunt Drive Suite 2400, Charlottesville, VA 22908 | 2017-03-31 |
| 1215399241 | Katherine Gresham Belote | Student in an Organized Health Care Education/Training Program | 1221 Lee Street Uva Health System, Charlottesville, VA 22908 | 2016-03-29 |
| 1851776215 | Catherine Meller | Student in an Organized Health Care Education/Training Program | 1215 Lee St., Box 800713, Charlottesville, VA 22908 | 2015-07-28 |
| 1295112597 | Breanna Campbell | Internal Medicine | 1220 Lee St Ste 2401, Charlottesville, VA 22908 | 2015-05-06 |
| 1013255637 | Melinda Bowles-childress | Nurse Practitioner | 1 Hospital Dr Fl 1, Charlottesville, VA 22908 | 2013-01-17 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1730241282 | Imre Noth | Internal Medicine | 1221 Lee St Fl 2, Charlottesville, VA 22908 | 2006-12-14 |
| 1023185394 | Tamer Ghanem | Otolaryngology | Dept. Otolaryngology, University of Virginia, 1 Hospital Dr., 2nd Floor Oms Rm 2747, Charlottesville, VA 22908 | 2006-11-29 |
| 1366401242 | Lisa M Christianson | Obstetrics & Gynecology | Uva Elson Student Health Center, 400 Brandon Avenue, Charlottesville, VA 22908 | 2006-03-21 |
| Find all providers in zip 22908 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801862867 | David Mark Rowe | Pathology | 3050 Berkmar Dr Ste A, Charlottesville, VA 22901-3405 | 2006-02-28 |
| 1861496648 | Mark W Teague | Pathology | 2331 Seminole Ln, Ste 102, Charlottesville, VA 22901-8319 | 2005-06-09 |
| 1730382581 | Catherine I Barry | Pathology | 2331 Seminole Lane, Suite 102, Charlottesville, VA 22901-8319 | 2007-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457713455 | Augusta Cancer Diagnostics | Pathology | 16 Ivy Ridge Ln, Suite 138, Fishersville, VA 22939-2354 | 2016-03-28 |
| 1811059983 | Jean Dobson Kemp | Pathology | 733 Boush St Ste 200, Norfolk, VA 23510-1591 | 2006-12-15 |
| 1548339682 | Virginia Pathology Svcs PC | Pathology | 6121 Lincolnia Rd, Suite 108, Alexandria, VA 22312 | 2006-11-06 |
| 1598739583 | Michael Thomas Ryan | Pathology | 733 Boush St, Suite 200, Norfolk, VA 23510-1501 | 2006-02-15 |
| 1508842956 | Alice A. Roberts | Pathology | 721 Fairfax Ave Ste 200, Norfolk, VA 23507-2007 | 2005-12-19 |
| 1114927092 | Earl Maxwell Hudgins | Pathology | 5421 Patterson Ave, Richmond, VA 23226-2003 | 2005-07-21 |
| 1447817689 | Loudoun Medical Group, P.C. | Pathology | 6736 Curran St Ste 1, Mc Lean, VA 22101-3803 | 2019-05-23 |
| 1326246927 | Jennifer M Reese | Pathology | 405 Glenn Dr, Suite #10a, Sterling, VA 20164-7119 | 2007-07-05 |
| 1649311861 | Alexander T. Ocampo | Pathology | 360 Maple Ave W, Suite F, Vienna, VA 22180-5614 | 2007-02-09 |
| 1407802572 | Barry Michael Shmookler | Pathology | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2006-05-26 |
| Find all providers with the same taxonomy | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22908 |
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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.