Individual provider Active NPI

Charles Lamar Nause Jr., DO

  • Family Medicine Physician
  • Greenwood, MS
National Provider Identifier
1154316008
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11262 Issued in MS
Practice address
110 E Market St
Greenwood, MS 38930-4430
Phone
(662) 453-5460
Fax
(662) 453-5551
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11262 MS Primary

Addresses

Primary practice location

110 E Market St
Greenwood, MS 38930-4430

Mailing address

110 E Market St
PO Box 1380
Greenwood, MS 38930-4430
Phone (662) 453-5460

Other identifiers 1

IdentifierTypeStateIssuer
00016402MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20071102000077 MS Practitioner - Family Practice 7517054851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 E Market St
Greenwood, MS 38930-4430
Phone (662) 453-5460

Hospital & facility affiliations

  • Adoration Home Health Care Mississippi Home health agency, Cleveland, MS, CCN 257305
  • Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131
  • Vitalcaring Group Home health agency, Cleveland, MS, CCN 257016
  • Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099
  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168
  • North Sunflower Medical Center Cah Hospital, Ruleville, MS, CCN 251318
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11262MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Charles L Nause PA Family Medicine CurrentSince Jun 5, 2008 Accepting new patients

Locations

110 E Market St
Greenwood, MS 38930
Phone (662) 453-5460

Organizations & group practices 2

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 8

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1154316008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MARKET ST",
            "address_2": "PO BOX 1380",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304430",
            "telephone_number": "662-453-5460",
            "fax_number": "662-453-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MARKET ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304430",
            "telephone_number": "662-453-5460",
            "fax_number": "662-453-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUSE",
        "first_name": "CHARLES",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "11262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016402",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.