Charles Gerard Landry, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

ME 1773 Issued in ME

Practice address

871 Court St
Auburn, ME 04210-3903

Phone

(207) 241-0401

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Osteopathic Manipulative Medicine

Education

University of New England, College of Osteo Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Landry Osteopathic Healthcare PA LLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Auburn, ME
  • NPI 1699238907
  Medicare reassignment NPD Authorized official
• University of New England

  • Physical Therapist
  • Portland, ME
  • NPI 1811974124
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1063418945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042120338",
            "telephone_number": "207-241-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 COURT ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103903",
            "telephone_number": "207-241-0401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Bowdoin St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "ME",
            "postal_code": "043513554",
            "country_code": "US",
            "telephone_number": "207-622-4500",
            "fax_number": "207-622-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "CHARLES",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "ME 1773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "022791",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3461045",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408470099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Lambert, FNP-C
• Lamey Wellehan Inc
• Sarah S Land, OT
• Kathryn Landry Gradwell, LCSW
• Landry Osteopathic Healthcare PA LLC
• Cynthia Ann Landry, RPH
• Justin Dennis Langis
• Corissa Lynne Laprell, MOT, OTR/L
• Janice Marie Lara-Hewey, L.C.S.W.
• Clifford B Larlee Jr., DMD

• Neuromusculoskeletal Medicine & OMM Physician in Auburn, ME
• Providers in Auburn, ME by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.