Organization Active NPI

Charles J Aswell III MD a Prof Medical Corp

  • Internal Medicine Physician
  • Ville Platte, LA
National Provider Identifier
1104939099
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHARLES J ASWELL III MD A PROF MEDICAL CORP
Practice address
503 Jack Miller Road
Ste a
Ville Platte, LA 70586
Phone
(337) 363-7474
Fax
(337) 363-1197
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Authorized official

Name
Dr. Charles Jesse Aswell III, MDNPI 1801842141
Title
Owner
Phone
(337) 363-7474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

503 Jack Miller Road
Ste a
Ville Platte, LA 70586

Mailing address

503 Jack Miller Road
Ste a
Ville Platte, LA 70586
Phone (337) 363-7474

Other identifiers 3

IdentifierTypeStateIssuer
1104939099OtherLAORGANIZATION NPI
1801842141OtherINDIVIDUAL NPI
1188531MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1104939099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 JACK MILLER ROAD",
            "address_2": "STE A",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "70586",
            "telephone_number": "337-363-7474",
            "fax_number": "337-363-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 JACK MILLER ROAD",
            "address_2": "STE A",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "70586",
            "telephone_number": "337-363-7474",
            "fax_number": "337-363-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J ASWELL III MD A PROF MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "ASWELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-363-7474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1104939099",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1801842141",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1188531",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ville Platte, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.