Active NPI
Sarah I Charles, PA
- Physician Assistant
- Albuquerque, NM
National Provider Identifier
1104075340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2008-0034
- Practice address
- 4650 Jefferson LN NE
Albuquerque, NM 87109-2127 - Phone
- (505) 889-9639
- Fax
- (505) 872-1745
- NPI assigned
- Sep 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2008-0034 | NM | Primary |
Addresses
Primary practice location
4650 Jefferson LN NE
Albuquerque, NM 87109-2127
Mailing address
4650 Jefferson LN NE
Albuquerque, NM 87109-2127
Phone (505) 889-9639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1104075340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 JEFFERSON LN NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871092127",
"telephone_number": "505-889-9639",
"fax_number": "505-872-1745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 JEFFERSON LN NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871092127",
"telephone_number": "505-889-9639",
"fax_number": "505-872-1745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "SARAH",
"middle_name": "I",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-11",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "PA2008-0034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.