Charles Wayne Dodgen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17100 Issued in GA

Practice address

107 Jackson Ave
Suite a
Thomaston, GA 30286-3433

Phone

(706) 647-8101

Fax

(706) 647-8543

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Family Practice

Education

Medical College of Georgia School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Columbus, GA, CCN 117306
• Amedisys Home Health of Griffin Home health agency, Griffin, GA, CCN 117045
• Thomaston Hospice, Inc Hospice, Thomaston, GA, CCN 111596
• Upson Regional Medical Center Hospital, Thomaston, GA, CCN 110002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• C. Wayne Dodgen, MD, PC

  • Family Medicine Physician
  • Thomaston, GA
  • NPI 1104022425

  Family Medicine, GA

  Medicare reassignment NPD Authorized official

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

• Amedisys Northwest, L.L.C.

  • Home Health Agency
  • Griffin, GA
  • NPI 1336197003
  Care Compare affiliation
• Caresouth HHA Holdings of Columbus, LLC

  • Home Health Agency
  • Columbus, GA
  • NPI 1750369245
  Care Compare affiliation
• Thomaston Hospice, Inc.

  • Community Based Hospice Care Agency
  • Thomaston, GA
  • NPI 1265521769

  Hospice

  Care Compare affiliation
• Upson County Hospital Inc

  • General Acute Care Hospital
  • Thomaston, GA
  • NPI 1659376630

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1104846625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 JACKSON AVE",
            "address_2": "SUITE A",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863433",
            "telephone_number": "706-647-8101",
            "fax_number": "706-647-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 JACKSON AVE",
            "address_2": "SUITE A",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863433",
            "telephone_number": "706-647-8101",
            "fax_number": "706-647-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGEN",
        "first_name": "CHARLES",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "17100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000116355B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Thomaston, GA
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.