Individual provider Active NPI

Mislynne Anita Charles, MD

  • Physical Medicine & Rehabilitation Physician
  • Glendale, CA
National Provider Identifier
1124198536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G56004 Issued in CA
Practice address
1509 Wilson Ter
Rehabilitation Institute
Glendale, CA 91206-4007
Phone
(818) 409-8088
Fax
(818) 546-5609
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G56004 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Rehabilitation Institute
Glendale, CA 91206-4007

Mailing address

1509 Wilson Ter
Rehabilitation Institute
Glendale, CA 91206-4007
Phone (818) 409-8088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20100201000098 CA Practitioner - Physical Medicine and Rehabilitation 1052454931 Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1509 Wilson Ter
Rehabilitation Institute
Glendale, CA 91206-4007

1509 Wilson Terrace
Glendale, CA 91206-4007

1509 Wilson Terrace
Glendale, CA 91206-4139
Phone (323) 260-5709

Hospital & facility affiliations

  • Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103
  • White Memorial Medical Center Inpatient rehabilitation facility, Los Angelos, CA, CCN 05T103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G56004CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Adventist Medical Center Past Accepting new patients
Dignity Community Care Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
White Memorial Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124198536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "address_2": "REHABILITATION INSTITUTE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8088",
            "fax_number": "818-546-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "address_2": "REHABILITATION INSTITUTE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8088",
            "fax_number": "818-546-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MISLYNNE",
        "middle_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G56004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.