MR. CHARLES DOUGLAS BALCOME (NPI# 1376027557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376027557 |
| Entity Type | Individual |
| Full Name | MR. CHARLES DOUGLAS BALCOME |
| Credential | ACNP |
| Practice Address |
16601 N 40th St Ste 227 Phoenix AZ 85032-3354 |
| Mailing Address |
10850 W. Angels Ln Sun City AZ 85373 |
| Practice Telephone | 6026333722 |
| Practice Fax Number | 6025951127 |
| Mailing Telephone | 6023359374 |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2019-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP11604 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
16601 N 40TH ST STE 227 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85032-3354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972575504 | Alicia Mangram | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2006-02-07 |
| 1043854623 | Dee Alley Ensign | Physician Assistant | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2019-11-06 |
| 1548756794 | Dustin Richard Husemann | Nurse Practitioner | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2018-07-10 |
| 1164809893 | Jennifer Rae Quezada | Registered Nurse | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2015-05-01 |
| 1770998007 | Thomas Cox | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2014-06-25 |
| 1164765731 | Tony Dunne | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2013-04-02 |
| 1649546193 | Ace Assaf Ovil | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2012-03-29 |
| 1831464858 | Alyssa Kristine Stassi | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2012-03-09 |
| 1821370974 | Affordable Family Practice, Inc. | Family Medicine | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2011-09-14 |
| 1891012225 | Hoang Lim | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2010-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298838 | Eboni Nicole Morris | Psychologist | 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 | 2020-06-03 |
| 1326688573 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3227 E Bell Road, Suite 170, Room P1, Phoenix, AZ 85032 | 2020-01-15 |
| 1740836642 | Integrated Medical Services Inc | Internal Medicine | 3815 W Bell Rd, Ste 3200, Phoenix, AZ 85032 | 2019-08-15 |
| 1639739576 | Sarah Martin | Physical Therapy Assistant | Ridgecrest Healthcare, 16640 North 38th Street, Phoenix, AZ 85032 | 2019-06-13 |
| 1750846168 | Conte Sport Performance Therapy LLC | Physical Therapist | 18413 N. Cave Creed Rd, Suite 8, Phoenix, AZ 85032 | 2019-02-11 |
| 1659848208 | Pacific Dental Services Foundation | Physician Assistant | 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 | 2018-10-31 |
| 1083100812 | Phoenix Interventional Pain Management, Pllc | Anesthesiology | 3815 E Bell Rd Ste 3500a, Phoenix, AZ 85032 | 2018-07-04 |
| 1770074635 | Np Professional LLC | Clinic/Center | 3329 E Bell Rd Ste A1, Phoenix, AZ 85032 | 2018-05-25 |
| 1932600020 | North Phoenix Asc LLC | Clinic/Center | 3329 E Bell Rd Ste A2-a5, Phoenix, AZ 85032 | 2018-02-23 |
| 1396263307 | Cheryl Anne Miller | Registered Nurse | 15002 N. 32nd St., Phoenix, AZ 85032 | 2017-08-30 |
| Find all providers in zip 85032 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890969 | Kristen Cox | Nurse Practitioner | 35714 N 34th Ln, Phoenix, AZ 85086-2264 | 2020-10-28 |
| 1760097570 | Justin Thomas Partlow | Nurse Practitioner | 3124 E Bloomfield Rd, Phoenix, AZ 85032-7109 | 2020-09-09 |
| 1295352334 | Adrian Emil Stamp | Nurse Practitioner | 12641 N 19th St, Phoenix, AZ 85022-5735 | 2020-07-04 |
| 1093332082 | Marissa Katherine Chase | Nurse Practitioner | 340 E Palm Ln # A175, Phoenix, AZ 85004-4603 | 2020-06-25 |
| 1033739081 | Anthony Populo | Nurse Practitioner | 1700 W Whitton Ave, Phoenix, AZ 85015-5533 | 2020-04-20 |
| 1710446786 | Rosa Maria Ruiz | Nurse Practitioner | 10317 W Campbell Ave, Phoenix, AZ 85037-5530 | 2019-03-18 |
| 1205394947 | Maryann Smith | Nurse Practitioner | 2327 W Dewdrop Trl, Phoenix, AZ 85085-0719 | 2019-03-12 |
| 1952868309 | Emily B Cova | Nurse Practitioner | 1331 N 7th St Ste 405, Phoenix, AZ 85006-2754 | 2019-02-21 |
| 1376027144 | Ejiro Ojameruaye | Nurse Practitioner | 19636 N 27th Ave Ste 202, Phoenix, AZ 85027-4018 | 2018-09-18 |
| 1538646161 | Joshua Alexander Luke Hindman | Nurse Practitioner | 1833 W Mission Ln, Phoenix, AZ 85021-2947 | 2018-07-26 |
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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.