Charles Anderson Roberson, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

87226 Issued in GA

Practice address

300 Medical Dr Ste 707
Lagrange, GA 30240-4130

Phone

(706) 880-7320

NPI assigned

Aug 28, 2006

Last updated

Apr 22, 2021By 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 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, MO, IA, IL4 enrollments

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 4

Specialty

Orthopedic Surgery

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Health SystemGroup PAC ID 6103829338, shared by 2 NPIs, 262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO C-SNP
• IA HMO

Interoperability endpoints

• Direct secure messaging: charles.roberson@880.chartlogic.direct-ci.com
• FHIR API: https://api.platform.athenahealth.com/4089/brand/1/csg/1/fhir/r4

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Southeast Missouri Hospital Physicians, LLC

  dba Mercy Clinic Southeast

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment NPD
• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Medicare reassignment
• Genesis Health System

  • Surgery Physician
  • Davenport, IA
  • NPI 1528616901
  Medicare reassignment
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Fox Medical Center

  • Family Medicine Physician
  • University Place, WA
  • NPI 1639748882
  NPD (past)
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421

  Orthopaedic Surgery

  NPD (past)
• Northwest Hand Specialists, Inc PS

  dba Hand and Wrist Surgery Center of Washington

  • Medical Specialty Clinic/Center
  • Shoreline, WA
  • NPI 1851316863
  NPD (past)
• Northwest Hand Specialists, Inc., P.S.

  • Orthopaedic Hand Surgery Physician
  • Shoreline, WA
  • NPI 1467493890
  NPD (past)

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

• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Genesis Health System

  dba Genesis Medical Center Davenport

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation
• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1033227202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340",
            "telephone_number": "770-792-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR STE 707",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404130",
            "telephone_number": "706-880-7320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Skyview Dr",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "98520",
            "country_code": "US",
            "telephone_number": "360-532-3808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "CHARLES",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "38947",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00042553",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "87226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL LICENSE",
            "identifier": "35.086840",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON MEDICAL LICENS",
            "identifier": "MD00042553",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE MEDICAL LICENSE",
            "identifier": "38947",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "croberson403389@directwellstar.org",
            "affiliation": "N",
            "address_1": "300 Medical Dr Ste 707",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Renal Associates of Lagrange LLC
• Renee Caverly-Gillett Counseling Services, LLC
• Rachael Rice, M.ED, APC, NCC
• Lanisha Carmen Rivers
• Joanne Robben, PT
• Teresa Roberson, NURSE
• Holly T Roberts
• Yvonnia J Robertson, LPC
• Amy Elizabeth Robinson, N.P.
• Lindsey Cole Robinson, DC

• Orthopaedic Surgery Physician in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.