Charles L Richert (NPI# 1043285604, PAC ID# 6608919741) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1043285604 |
PAC ID by PECOS | 6608919741 |
Professional Enrollment ID | I20100211000343 |
Full Name | Charles L Richert |
Organization Legal Name | GRAND OLE DOCS OF THE SOUTHSIDE LLC |
Address |
365 E Main St Central Indiana Medical Group Greenwood IN 46143-1361 |
Phone Number | 3178815152 |
Gender | M |
Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
Graduation Year | 1985 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 3779671441 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
150128 | COMMUNITY HOSPITAL SOUTH, INC. |
150162 | FRANCISCAN HEALTH INDIANAPOLIS |
150001 | JOHNSON MEMORIAL HOSPITAL |
150056 | INDIANA UNIVERSITY HEALTH METHODIST HOSPITAL (INDIANAPOLIS) |
150074 | COMMUNITY HOSPITAL EAST |
Address | Phone | Organization |
---|---|---|
365 E Main St, Central Indiana Medical Group, Greenwood, IN 46143-1361 | 3178815152 | GRAND OLE DOCS OF THE SOUTHSIDE LLC |
Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
---|---|---|---|
MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 99% | |
MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | |
MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
MIPS_EC_134_overall | Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | 100% | |
MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
Organization Legal Name | GRAND OLE DOCS OF THE SOUTHSIDE LLC |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Robert V Klaasen | Family Medicine | Grand Ole Docs of The Southside LLC | 365 E Main St, Central Indiana Medical Group, Greenwood, IN 46143-1361 |
Street Address |
365 E MAIN ST CENTRAL INDIANA MEDICAL GROUP |
City | GREENWOOD |
State | IN |
Zip | 46143-1361 |
Name | Specialty | Organization | Address |
---|---|---|---|
Bernice L. Bouzy | Nurse Practitioner | Hudson River Healthcare Inc | 365 E Main St, Patchogue, NY 11772-3145 |
Veronica T Stephan | Physician Assistant | Hudson River Healthcare Inc | 365 E Main St, Patchogue, NY 11772-3145 |
Robert S Sparks | Chiropractic | 365 E Main St, Lancaster, OH 43130-3845 | |
Elizabeth K Bonner | Clinical Social Worker | Brookhaven Memorial Hospital Medical Center | 365 E Main St, Patchogue, NY 11772-3145 |
Sabrina Johnson | Family Medicine | Hudson River Healthcare Inc | 365 E Main St, Patchogue, NY 11772-3145 |
Robert V Klaasen | Family Medicine | Grand Ole Docs of The Southside LLC | 365 E Main St, Central Indiana Medical Group, Greenwood, IN 46143-1361 |
Shashi Berdia | Psychiatry | Brookhaven Memorial Hospital Medical Center | 365 E Main St, Patchogue, NY 11772-3145 |
Jacquelyn Gilde | Clinical Social Worker | Brookhaven Memorial Hospital Medical Center | 365 E Main St, Patchogue, NY 11772-3145 |
Pedram Samghabadi | Clinical Social Worker | Brookhaven Memorial Hospital Medical Center | 365 E Main St, Patchogue, NY 11772-3145 |
Robin Gardner | Clinical Social Worker | Brookhaven Memorial Hospital Medical Center | 365 E Main St, Patchogue, NY 11772-3145 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Minesh Dinesh Rajkotia | Family Medicine | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Tracy Renee Hammond | Nurse Practitioner | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Mery A Kendall | Family Medicine | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Charles Angelo Salazar | Obstetrics/gynecology | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Ryan J. Sanderson | Family Medicine | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Angela Denise Morris | Nurse Practitioner | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Anneke Elisabeth Warren Nave | Clinical Social Worker | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Debra K Taylor | Nurse Practitioner | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Priyanka Agrawal | Family Medicine | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Erica Pohlman | Internal Medicine | Community Physicians of Indiana Inc | 333 E Co Line Rd B, Greenwood, IN 46143-1046 |
Find all physicians in zip 46143 |
City | GREENWOOD |
Zip Code | 46143 |
Specialty | FAMILY MEDICINE |
City + Specialty | GREENWOOD + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Charles L Richert.
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.