Charles R Haendel, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD000583 Issued in GA

Practice address

55 Whitcher St NE
Ste 450
Marietta, GA 30060-1155

Phone

(770) 590-4188

Fax

(770) 590-4189

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Cobb Foot & Leg Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Marietta, GA
  • NPI 1336123264
  NPD
• Marietta Podiatry Group

  • Durable Medical Equipment & Medical Supplies
  • Marietta, GA
  • NPI 1306960836
  NPD
• Marietta Podiatry Group

  • Podiatric Clinic/Center
  • Marietta, GA
  • NPI 1487638318

  Podiatrist

  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1124002050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "STE 450",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-590-4188",
            "fax_number": "770-590-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "STE 450",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-590-4188",
            "fax_number": "770-590-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAENDEL",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000583",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000377869G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "024633",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0575829",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie Hackler III, M.D.
• Edmond F. Hackney, RPH
• Melanie Hackney, PMHNP-BC
• Shana Boyd Hackworth, PHYSICIAN ASSISTANT
• Jeremy Eric Hadibe, DDS
• Joseph Vance Haezebrouck, D.C.
• David H. Hafner, M.D.
• Colleen L Hagan
• Terris Leigh Hagan
• Miah J Hagans, MD, MPH

• Foot & Ankle Surgery Podiatrist in Marietta, GA
• Providers in Marietta, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.