Charles M Lederer Jr., M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

R8629 Issued in MO

Practice address

506 Burkarth Rd
A
Warrensburg, MO 64093-3104

Phone

(660) 747-2202

Fax

(660) 747-1223

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cokingtin Eye Center PA

  • Ophthalmology Physician
  • Harrisonville, MO
  • NPI 1477511335
  NPD
• University Health Physicians

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1669456257
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1174544845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 W 125TH ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662092427",
            "telephone_number": "913-327-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 BURKARTH RD",
            "address_2": "A",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640933104",
            "telephone_number": "660-747-2202",
            "fax_number": "660-747-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERER",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R8629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09486042",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09486052",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Lake, O.D.
• Lawrence Paul Landwehr, M.D.
• Mallory Langkrahr, LCSW
• Courtney Ann Langston, LCSW
• Lindsay Ann Lawrence, DPT, ATC
• Natalie Diana Leitzel, COTA/L
• Lindsey Rae Lewis, PTA
• Monique Chante Leyvas, LMSW
• Christopher Scott Lichte, DPT
• Adriatik Likcani, LMFT

• Ophthalmology Physician in Warrensburg, MO
• Providers in Warrensburg, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.