Charles C Boackle, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

10381 Issued in AL

Practice address

513 Brookwood Blvd
Suite 50
Birmingham, AL 35209-6862

Phone

(205) 877-2761

Fax

(205) 877-2399

NPI assigned

Aug 30, 2006

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 4

Medicare fee-for-service enrollment

Enrolled in AL

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

Internal Medicine

Education

University of Alabama School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brookwood Internists PCGroup PAC ID 6406875418, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent'S Birmingham Hospital, Birmingham, AL, CCN 010056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.boackle@brookwoodinternists.directbygreenway.com

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.

• Brookwood Internists PC

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1316056328

  AL, Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• St. Vincent'S Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1841298999

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1104935287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BROOKWOOD BLVD",
            "address_2": "SUITE 50",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096862",
            "telephone_number": "205-877-2761",
            "fax_number": "205-877-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BROOKWOOD BLVD",
            "address_2": "SUITE 50",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096862",
            "telephone_number": "205-877-2761",
            "fax_number": "205-877-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOACKLE",
        "first_name": "CHARLES",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "10381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "631266801 0054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110224927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "C73058",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009960790",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blunt Counseling and Consulting, LLC
• Felicity Neicole Blunt, MA, LPC
• Isabella Blutcher, RBT
• James Clifton Blutcher
• BMX Health LLC
• Kimberly C Boackle, CRNP
• Tomie Ann Boackle, PHARM.D.
• Daniel Riley Boalch
• Taylor Boatwright, PA-C
• Brenda Joyce Bobbitt, MSPCCCSLP

• All providers in Birmingham, AL
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.