Active NPI
Charles Lionel Staats, PA
- Physician Assistant
- Allen, TX
National Provider Identifier
1144267048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA01276
- Practice address
- 1105 Central Expy N
Ste 120
Allen, TX 75013-6103 - Phone
- (972) 727-9995
- Fax
- (972) 727-8350
- NPI assigned
- May 31, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA01276 | TX | |
| Physician Assistant | 363A00000X | PA01276 | TX | Primary |
Addresses
Primary practice location
1105 Central Expy N
Ste 120
Allen, TX 75013-6103
Mailing address
1105 Central Expy N
Ste 120
Allen, TX 75013-6103
Phone (972) 727-9995
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 835N16 | Other | TX | BC/BS TX - EFFECT. 02/01/2011 |
| TXB121232 | Other | TX | MEDICARE PART B EFFECT 02/01/2011 |
| 87N310 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA01276 | TX | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1144267048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 CENTRAL EXPY N",
"address_2": "STE 120",
"city": "ALLEN",
"state": "TX",
"postal_code": "750136103",
"telephone_number": "972-727-9995",
"fax_number": "972-727-8350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 CENTRAL EXPY N",
"address_2": "STE 120",
"city": "ALLEN",
"state": "TX",
"postal_code": "750136103",
"telephone_number": "972-727-9995",
"fax_number": "972-727-8350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAATS",
"first_name": "CHARLES",
"middle_name": "LIONEL",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA01276",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA01276",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS TX - EFFECT. 02/01/2011",
"identifier": "835N16",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B EFFECT 02/01/2011",
"identifier": "TXB121232",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "87N310",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.