Charlie Becknell, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

21532 Issued in KY

Practice address

250 Fountain CT
Lexington, KY 40509-1888

Phone

(859) 263-4444

Fax

(859) 254-1814

NPI assigned

May 31, 2005

Last updated

Dec 16, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1033112453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 FOUNTAIN CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091888",
            "telephone_number": "859-263-4444",
            "fax_number": "859-254-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 FOUNTAIN CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091888",
            "telephone_number": "859-263-4444",
            "fax_number": "859-254-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKNELL",
        "first_name": "CHARLIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "21532",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "KY",
            "license": "21532",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64215320",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CUMBERLAND HEALTHCARE",
            "identifier": "C03007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000044793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0300056",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Becker
• Stephanie Becker
• Jennifer R Beckham
• Loren E Beckham, CADC
• Alan C. Beckman, M.D.
• Mary Prickett Bedinger, MD
• Bee Active, LLC
• Ann Lyon Beebe, OTR/L
• Steven Trent Beeghly, APRN
• Noelle Beeler, CSW

• Dermatology Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.