Charles H Mathis (NPI# 1750380382, PAC ID# 6103812722) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1750380382 |
| PAC ID by PECOS | 6103812722 |
| Professional Enrollment ID | I20040421000287 |
| Full Name | Charles H Mathis |
| Organization Legal Name | LOGAN PHYSICIAN PRACTICE LLC |
| Address |
975 Hopkinsville Rd Russellville KY 42276-9774 |
| Phone Number | 2707259090 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 1960 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4880596592 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180066 | LOGAN MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 975 Hopkinsville Rd, Russellville, KY 42276-9774 | 2707259090 | LOGAN PHYSICIAN PRACTICE LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | LOGAN PHYSICIAN PRACTICE LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adam W Ellis | General Surgery | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| James C Dodson | Internal Medicine | Logan Physician Practice LLC | 147 E 5th St, Russellville, KY 42276-1903 |
| Cynthia Jo Bond | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Blair R Mendoza | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Gillian J Stuart | General Surgery | Logan Physician Practice LLC | 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 |
| Stephanie Diane Geraci | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Steve G Salyers | Orthopedic Surgery | Logan Physician Practice LLC | 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 |
| Cynthia J Finley | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Trisha K Campbell | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Street Address |
975 HOPKINSVILLE RD |
| City | RUSSELLVILLE |
| State | KY |
| Zip | 42276-9774 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven Robert Zeller | Family Medicine | Community Health Centers of Western Kentucky, Inc. | 975 Hopkinsville Rd, Russellville, KY 42276-9774 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thad Dustin Wells | Optometry | 105 Robins Way, Suite 206, Russellville, KY 42276-1129 | |
| Darla S Barrow | Optometry | 102 Armory Dr, Russellville, KY 42276-1602 | |
| Amanda S Higdon | Optometry | 102 Armory Dr, Russellville, KY 42276-1602 | |
| Keith A Jones | Chiropractic | 178 E 4th St, Russellville, KY 42276-1820 | |
| Bill D Webb | Optometry | 603 E 4th St, Russellville, KY 42276-1857 | |
| James C Dodson | Internal Medicine | Logan Physician Practice LLC | 147 E 5th St, Russellville, KY 42276-1903 |
| Stuart W Larson | Psychiatry | Lifeskills, Inc | 237 E 6th St, Russellville, KY 42276-1917 |
| Tonya Norris Ballard | Clinical Social Worker | Lifeskills, Inc | 237 E 6th St, Russellville, KY 42276-1917 |
| Lorri L Houck | Nurse Practitioner | Lifeskills, Inc | 237 E 6th St, Russellville, KY 42276-1917 |
| Laura A Gaines | Clinical Social Worker | Lifeskills, Inc | 237 E 6th St, Russellville, KY 42276-1917 |
| Find all physicians in zip 42276 | |||
| City | RUSSELLVILLE |
| Zip Code | 42276 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | RUSSELLVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Charles H Mathis.
| 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.