CHARLES C CARTER MD DPH PLLC (NPI# 1326095381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326095381 |
| Entity Type | Organization |
| Organization Name | CHARLES C CARTER MD DPH PLLC |
| Other Organization Name | CHARLES C CARTER MD DPH |
| Practice Address |
1015 E Broadway St Suite 102 Altus OK 73521 |
| Mailing Address |
Po Box 575 Altus OK 73522-0575 |
| Practice Telephone | 5804801600 |
| Practice Fax Number | 5804801601 |
| Mailing Telephone | 5804801600 |
| Mailing Fax Number | 5804801601 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-05-21 |
| Authorized Official Name | DR. CHARLES C CARTER (OWNER PHYSICIAN) |
| Authorized Official Telephone | 5804801600 |
| Authorized Official Credential | MD DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 19154 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | OK STATE LICENSE # | 19154 | 01 |
| OK | CLIA WAIVED | 37D1053611 | 01 |
| OK | 200113300A | 05 | |
| OK | SOCIAL SECURITY NUMBER | $$$$$$$$$ | 01 |
| OK | 100116810D | 05 | |
| AR | ARKANSAS STATE LICENSE # | C-8500 | 01 |
| OK | 100116810E | 05 | |
| OK | TRICARE/HUMANA PROVIDER # | 203705843 | 01 |
| OK | BCBS BILLING # | 445440041004 | 01 |
| Other Name | Type Code |
|---|---|
| Charles C Carter MD DPh | Former Legal Business Name - Organization |
| Street Address |
1015 E BROADWAY ST SUITE 102 |
| City | ALTUS |
| State | OK |
| Zip Code | 73521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437516788 | Tammy Lynn Carter | Nurse Practitioner | 1015 E Broadway St, Suite 101, Altus, OK 73521-5505 | 2016-01-18 |
| 1194193433 | Altus Urgent Care, LLC | Clinic/Center | 1015 E Broadway St, Suite 101, Altus, OK 73521-5505 | 2015-09-03 |
| 1528087590 | Barry Eugene Chapman | Nurse Practitioner | 1015 E Broadway St, Suite 102, Altus, OK 73521-5505 | 2006-07-19 |
| 1730129750 | Charles C Carter | Family Medicine | 1015 E Broadway St, Suite 102, Altus, OK 73521-5520 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
| 1598025827 | Dustin James Robins | Counselor | 1052 E Cherry St, Altus, OK 73521 | 2012-05-21 |
| 1831471101 | Manda Lea Stephens | Nurse Practitioner | 205 S. Park Lane, Altus, OK 73521 | 2011-09-13 |
| 1649439167 | Lisa Michelle Shelton | Pharmacist | 2500 N Main, Altus, OK 73521 | 2008-06-09 |
| 1114192911 | Richard G. Henry | Health Maintenance Organization | 112 Val Verde, Altus, OK 73521 | 2008-04-23 |
| 1194881060 | Resters Diabetic Shoes and Home Medical | Durable Medical Equipment & Medical Supplies | 103 West Commerce Street, Altus, OK 73521 | 2006-12-28 |
| 1265592141 | Noble L Ballard.medical Clinic, Pllc | Family Medicine | 1015 East Broadway Street, Stuite 101, Altus, OK 73521 | 2006-12-11 |
| 1457377822 | Comanche County Healthcare | Family Medicine | 3000 N Main St, Suite A, Altus, OK 73521 | 2006-07-15 |
| 1013988179 | Carol Marie Sherman | Family Medicine | 205 S Park Ln, Altus, OK 73521 | 2006-01-27 |
| 1235112426 | Air Evac Ems Inc | Ambulance | 6333 N Main Street, Altus, OK 73521 | 2005-11-22 |
| Find all providers in zip 73521 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528449642 | Matthew Albright | Family Medicine | 301 N 1st St # 46, Altus, OK 73523-5004 | 2015-06-15 |
| 1265592141 | Noble L Ballard.medical Clinic, Pllc | Family Medicine | 1015 East Broadway Street, Stuite 101, Altus, OK 73521 | 2006-12-11 |
| 1457377822 | Comanche County Healthcare | Family Medicine | 3000 N Main St, Suite A, Altus, OK 73521 | 2006-07-15 |
| 1013988179 | Carol Marie Sherman | Family Medicine | 205 S Park Ln, Altus, OK 73521 | 2006-01-27 |
| 1871589341 | John C Root | Family Medicine | 1200 East Pecan Street, Altus, OK 73521 | 2005-09-21 |
| 1659738953 | Altus Minor Emergency & Family Practice | Family Medicine | 916 N Main St, Altus, OK 73521-3118 | 2016-01-19 |
| 1962742999 | Phillip Tyler Price | Family Medicine | 301 N 1st St, Bldg. 46, Altus, OK 73523-5004 | 2013-02-28 |
| 1528322476 | Alejandro Pacheco | Family Medicine | 205 S Park Ln, Altus, OK 73521-5755 | 2012-06-26 |
| 1093021016 | Ama Isaac | Family Medicine | 205 S Park Ln, Suite 210, Altus, OK 73521-5755 | 2010-08-27 |
| 1275847303 | Lonnie Edwin Perryman Jr. | Family Medicine | 205 S Park Ln, Altus, OK 73521-5755 | 2010-07-30 |
| Find all providers in ALTUS | ||||
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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.