Charles Wheeler Novak, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R119086 Issued in MD

Practice address

12145 Elm St
Princess Anne, MD 21853-1358

Phone

(410) 651-2204

Fax

(410) 651-0790

NPI assigned

Jan 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1144405580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12145 ELM ST",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531358",
            "telephone_number": "410-651-2204",
            "fax_number": "410-651-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "CHARLES",
        "middle_name": "WHEELER",
        "name_prefix": "Mr.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-03",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R119086",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024168080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Nativio, LAT
• Next Chapter Behavioral Health LLC
• Next Chapter Behavioral Health LLC
• Next Chapter Behavioral Health LLC
• Geoffrey Ngam
• Nu Pathway Healthcare and Wellness LLC
• Kristine Oladayo Oladipo, DDS
• Palmetto Corner, LLC
• James Hyun Park, PHARMD
• Donna F Parker, MD

• Psychiatric/Mental Health Nurse Practitioner in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.