Charles P O'Brien, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2515 Issued in SD

Practice address

1305 W 18TH St
Sioux Falls, SD 57105-0401

Phone

(605) 328-2929

Fax

(605) 328-8429

NPI assigned

Jun 16, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• LCM Pathologists PC

  • Clinical Medical Laboratory
  • Sioux Falls, SD
  • NPI 1770742496
  NPD (past)
• Sioux Valley Heart Partners

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1033127956
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124023171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9556",
            "fax_number": "605-328-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-328-2929",
            "fax_number": "605-328-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "CHARLES",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "2515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000883",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ukamaka N Nwadibia, MD
• Ellisa Nyberg, MS, RDN, LN, LD
• Timothy A. Nydam, M.D.
• Verlyn Jon Nykamp, M.D.
• O & P Innovations Inc.
• Jessica O'Brien, PHARMD
• Patrick Mark O'Brien, M.D.
• Peter O'Brien, MD
• Marla K O'Bryan, ATC
• Lynda I O'Connor-Ohayon, ED.D.

• Internal Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Internal Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.