Individual provider Active NPI

Charles Crowell Pierce, PA

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1013973791
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05595 Issued in TX
Practice address
619 S Fleishel Ave Ste 305
Tyler, TX 75701-2004
Phone
(903) 606-1173
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05595 TX Primary

Addresses

Primary practice location

619 S Fleishel Ave Ste 305
Tyler, TX 75701-2004

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other practice location 1

3131 Troup Hwy
Tyler, TX 75701-8350
Phone (903) 510-7006

Other practice location 2

619 S Fleishel Ave Ste 327
Tyler, TX 75701-2019
Phone (903) 606-1173

Other practice location 3

910 E Houston St Ste 330
Tyler, TX 75702-8368
Phone (903) 606-7995

Other practice location 4

1327 Troup Hwy
Tyler, TX 75701-4443
Phone (903) 606-1173

Other identifiers 5

IdentifierTypeStateIssuer
214077401MedicaidTX
752616977-103OtherTXTRICARE
75-2616977-095OtherTXTRICARE
824N49OtherTXBCBS
752616977006OtherTXTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000073 TX Practitioner - Physician Assistant 1557396264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

1302 N Pacific St
Christus Trinity Clinic
Mineola, TX 75773-1022
Phone (903) 569-5383

1327 Troup Hwy
Tyler, TX 75701-4443
Phone (903) 510-8764

1720 S Beckham Ave
Tyler, TX 75701-4464

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

3203 S Main St
Christus Trinity Clinic
Lindale, TX 75771-7727
Phone (903) 266-4000

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

650 E Lennon Dr
Christus Trinity Clinic
Emory, TX 75440-3227
Phone (903) 473-7234

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
  • Christus Mother Frances Hospital- Winnsboro Hospital, Winnsboro, TX, CCN 451381
  • Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05595TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2010 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2010 Accepting new patients
Medical Rehabilitation Physicians PLC Past Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

619 S Fleishel Ave
Ste 327
Tyler, TX 75701
Phone (903) 510-1173

619 S Fleishel Ave
Ste 305
Tyler, TX 75701
Phone (903) 606-1173

3131 Troup Hwy
Tyler, TX 75701
Phone (903) 510-7000

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764

910 E Houston St
Ste 330
Tyler, TX 75702
Phone (903) 510-8718

Interoperability endpoints

  • Direct secure messaging: cpierce7023@christushealth.direct-ci.net

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1013973791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S FLEISHEL AVE STE 305",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012004",
            "telephone_number": "903-606-1173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018350",
            "country_code": "US",
            "telephone_number": "903-510-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 S Fleishel Ave Ste 327",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012019",
            "country_code": "US",
            "telephone_number": "903-606-1173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 E Houston St Ste 330",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028368",
            "country_code": "US",
            "telephone_number": "903-606-7995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1327 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757014443",
            "country_code": "US",
            "telephone_number": "903-606-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "CHARLES",
        "middle_name": "CROWELL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214077401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "752616977-103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-095",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "824N49",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "752616977006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.