Charles E Drake (NPI# 1871684027, PAC ID# 4385732833) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1871684027 |
| PAC ID by PECOS | 4385732833 |
| Professional Enrollment ID | I20071116000046 |
| Full Name | Charles E Drake |
| Organization Legal Name | SJC MEDICAL GROUP, INC |
| Address |
5353 Reynolds St Savannah GA 31405-6015 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1977 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 7719978105 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110024 | CANDLER HOSPITAL |
| 110043 | ST JOSEPH'S HOSPITAL - SAVANNAH |
| 111323 | OPTIM MEDICAL CENTER - TATTNALL |
| Address | Phone | Organization |
|---|---|---|
| 11705 Mercy Blvd, Savannah, GA 31419-1711 | 9128194100 | SJC MEDICAL GROUP, INC |
| 5353 Reynolds St, Savannah, GA 31405-6015 | SJC MEDICAL GROUP, INC |
| Organization Legal Name | SJC MEDICAL GROUP, INC |
| Physicians | 53 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Harley Randall Hendrix | Family Medicine | Sjc Medical Group, Inc | 159 W Railroad St, Pembroke, GA 31321-0190 |
| Matthew G Marshall | Neurology | Sjc Medical Group, Inc | 410 Mall Blvd E, Savannah, GA 31406-4869 |
| Aaron Webb | Nurse Practitioner | Sjc Medical Group, Inc | 423 S Columbia Ave, Rincon, GA 31326-9080 |
| David Orlando Caraballo | Physician Assistant | Sjc Medical Group, Inc | 10 Oak Forest Rd C, Bluffton, SC 29910-4974 |
| Keith A Rouse Sr. | Podiatry | Sjc Medical Group, Inc | 310 Eisenhower Dr, Bldg 7a, Savannah, GA 31406-2688 |
| Russell William Lake | Family Medicine | Sjc Medical Group, Inc | 105 Grand Central Blvd, Suite 107, Pooler, GA 31322-4148 |
| Jose M Rendon-garcia | Internal Medicine | Sjc Medical Group, Inc | 11705 Mercy Blvd, Savannah, GA 31419-1711 |
| Marianne M Fleming | Internal Medicine | Sjc Medical Group, Inc | 836 E, 65th Suite 30, Savannah, GA 31405 |
| Richard J Barrett | Internal Medicine | Sjc Medical Group, Inc | 102 Bryan Woods Rd, Savannah, GA 31410-1225 |
| Frederic C Spector | Podiatry | Sjc Medical Group, Inc | 352 Commercial Dr, Savannah, GA 31406-3616 |
| Street Address |
5353 REYNOLDS ST |
| City | SAVANNAH |
| State | GA |
| Zip | 31405-6015 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ian Christopher Munger | Emergency Medicine | Georgia Emergency Associates | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Ashley B Stone | Certified Registered Nurse Anesthetist (crna) | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Kerin Harris | Certified Registered Nurse Anesthetist (crna) | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Abigail White | Certified Registered Nurse Anesthetist (crna) | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Jayesh B Bodalia | Anesthesiology Assistant | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Moses T Laffitte | Emergency Medicine | Georgia Emergency Associates | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Edward B Orand | Anesthesiology Assistant | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Angela D Gerrald | Certified Registered Nurse Anesthetist (crna) | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| John Conrad Gouse | Diagnostic Radiology | Savannah Chatham Imaging LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Sarah Thomasson Oss | Certified Registered Nurse Anesthetist (crna) | American Anesthesiology Associates of Georgia LLC | 5353 Reynolds St, Savannah, GA 31405-6015 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marianne M Fleming | Internal Medicine | Sjc Medical Group, Inc | 836 E, 65th Suite 30, Savannah, GA 31405 |
| Julia Johnson | Hospice/palliative Care | Steward Center for Palliative Care | 5353 Reynolds Ave, Savannah, GA 31405 |
| Sandra W Gordon-kolb | Internal Medicine | Steward Center for Palliative Care | 5353 Reynolds Ave, Savannah, GA 31405 |
| Kristina N Johnson | Family Medicine | Savannah Primary Care Associates LLC | 3776 Hwy 17 S, Savannah, GA 31405-1310 |
| Lakeia M Manor | Chiropractic | Manor Chiropractic LLC | 3025 Bull St, Savannah, GA 31405-2016 |
| Jason Miller | Physician Assistant | Chatham Orthopaedic Associates Pa | 4425 Paulsen St, A, Savannah, GA 31405-3637 |
| Mary Ann Kilgore | Physical Therapy | Chatham Orthopaedic Associates Pa | 4425 Paulsen St, A, Savannah, GA 31405-3637 |
| Emma Katherine L Mcintosh | Physician Assistant | Chatham Orthopaedic Associates Pa | 4425 Paulsen St, A, Savannah, GA 31405-3637 |
| Ray L Wallace | Physician Assistant | Chatham Orthopaedic Associates Pa | 4425 Paulsen St, A, Savannah, GA 31405-3637 |
| Andrew Vincent Grosse | Physician Assistant | Chatham Orthopaedic Associates Pa | 4425 Paulsen St, A, Savannah, GA 31405-3637 |
| Find all physicians in zip 31405 | |||
| City | SAVANNAH |
| Zip Code | 31405 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | SAVANNAH + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
Please comment or provide details below to improve the information on Charles E Drake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.