Charles Pradieu, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

15061 Issued in PR

Practice address

100 S Bliss Ave
100 South Bliss Ave
Tahlequah, OK 74464-2512

Phone

(918) 458-3100

NPI assigned

Nov 2, 2005

Last updated

Jan 10, 2011By the provider in NPPES

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 names 1

• Dr. Charles Pradieu Professional name

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anadarko Indian Health Center

  • Federal Public Health Clinic/Center
  • Anadarko, OK
  • NPI 1881637403

  TX

  Medicare reassignment NPD
• El Reno Indian Health Center

  • Public Health or Welfare Agency
  • El Reno, OK
  • NPI 1386725604

  TX

  Medicare reassignment NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1114918778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 ATHERTON AVE",
            "address_2": "1743 ATHERTON AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031744",
            "telephone_number": "516-424-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BLISS AVE",
            "address_2": "100 SOUTH BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642512",
            "telephone_number": "918-458-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADIEU",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "15061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "PRADIEU",
            "prefix": "DR.",
            "credential": ".M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Todd K Pogue, DO
• Brandy Ponder, APRN
• Amanda Post
• William Ray Potts, D. PH.
• Gena Powers
• Premiere Dentistry of Tahlequah
• Premiere Dentistry of Tahlequah, P.C.
• Premiere Family Dentistry of Tahlequah, PLLC
• Jesse Lee Price, LCSW
• Prime Medical Outlet LLC

• Specialist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.