Individual provider Active NPI

Charles Allen Rodman IV, D.O.

  • Emergency Medicine Physician
  • Claremore, OK
National Provider Identifier
1013124031
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4328 Issued in OK
Practice address
Claremore Regional Hospital
1415 N. Muskogee PL
Claremore, OK 74017
Phone
(918) 341-2556
NPI assigned
May 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4328 OK Primary

Addresses

Primary practice location

Claremore Regional Hospital
1415 N. Muskogee PL
Claremore, OK 74017

Mailing address

11311 S Kingston Ave
Tulsa, OK 74137-7734
Phone (918) 296-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070730000782 OK Practitioner - Emergency Medicine 1153422464 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4328OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Feb 27, 2008 Accepting new patients
Warren Clinic Inc CurrentSince Apr 12, 2021 Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Norstar Emergency Physicians Past Accepting new patients
Jane Phillips Memorial Medical Center, Inc. Past Accepting new patients
Saint Francis Hospital Muskogee Inc Past Accepting new patients
St. John Broken Arrow, Inc Past Accepting new patients
Saint Francis Hospital Vinita, Inc Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013124031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 S KINGSTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377734",
            "telephone_number": "918-296-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLAREMORE REGIONAL HOSPITAL",
            "address_2": "1415 N. MUSKOGEE PL",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "74017",
            "telephone_number": "918-341-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODMAN",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.