Charles O Shoetan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N6669 Issued in TX

Practice address

7048 Bissonnet St
Houston, TX 77074-6010

Phone

(713) 776-3906

NPI assigned

Nov 30, 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 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cshoetan@yourcarecommunity.org

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.

• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Family Medicine

  Medicare reassignment NPD
• Ut Physicians

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD
• Crescent City Physicians, Inc.

  • Family Medicine Physician
  • New Orleans, LA
  • NPI 1689722340
  NPD (past)
• Swla Center for Health Services

  • Federally Qualified Health Center (FQHC)
  • Crowley, LA
  • NPI 1336383033
  NPD (past)
• Swla Center for Health Services

  • Pediatrics Physician
  • Lafayette, LA
  • NPI 1366111791
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1114095023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 AUGUSTA DR",
            "address_2": "# 308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573731",
            "telephone_number": "713-952-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7048 BISSONNET ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770746010",
            "telephone_number": "713-776-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOETAN",
        "first_name": "CHARLES",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N6669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280332202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09659298",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280332201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Nichole Shockley, PHARMD
• Sherouk Shoeib, MBBCH
• Kelsie Anne Shoemake, PA-C
• Mary Katherine Shoemaker, MD
• Norman Alan Shoenfeld, M.D.
• Ben Shofty, MD
• Daniel Shoham, M.D.
• Bahareh Shojaeimehr
• Mayada Shokeir
• Rudo Shoko

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.