Active NPI
Charles Roy Wirth IV
- Registered Nurse
- Georgetown, TX
National Provider Identifier
1134037021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 983839
- Practice address
- 1101 Plateau TRL
Georgetown, TX 78626-7148 - Phone
- (512) 577-5210
- NPI assigned
- Aug 31, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 983839 | TX | Primary |
Addresses
Primary practice location
1101 Plateau TRL
Georgetown, TX 78626-7148
Mailing address
1101 Plateau TRL
Georgetown, TX 78626-7148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1134037021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 PLATEAU TRL",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786267148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 PLATEAU TRL",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786267148",
"telephone_number": "512-577-5210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRTH",
"first_name": "CHARLES",
"middle_name": "ROY",
"name_prefix": "Mr.",
"name_suffix": "IV",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-31",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "983839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.