Individual provider Active NPI

Charles R Friend, D.O.

  • Family Medicine Physician
  • Crawfordsville, IN
National Provider Identifier
1184638868
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02001804A Issued in IN
Practice address
1640 Crawfordsville Square Dr
Crawfordsville, IN 47933-3800
Phone
(765) 362-5789
Fax
(765) 362-2453
NPI assigned
Jul 28, 2006
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS10246 FL
Family Medicine Physician 207Q00000X 02001804A IN Primary

Addresses

Primary practice location

1640 Crawfordsville Square Dr
Crawfordsville, IN 47933-3800

Mailing address

PO Box 781076
Detroit, MI 48278-3833
Phone (317) 528-4800

Other practice location 1

3480 Deltona Blvd
Spring Hill, FL 34606-2917
Phone (352) 600-7900

Other practice location 2

5429 Commercial Way
Spring Hill, FL 34606-1110
Phone (352) 600-4390

Other practice location 3

5446 Land O Lakes Blvd
Land O Lakes, FL 34639-3413
Phone (813) 461-7180

Other practice location 4

6719 Gall Blvd Ste 206
Zephyrhills, FL 33542-2569
Phone (813) 708-6990

Other identifiers 8

IdentifierTypeStateIssuer
000000371599OtherINANTHEM
280728900MedicaidFL
14150OtherFLBCBS
P01368092OtherINRAIL ROAD MEDICARE
000000891732OtherINANTHEM
200528320MedicaidIN
201246920MedicaidIN
5517084OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050628000247 IN Practitioner - Family Practice 8022053263 Reassigns benefits to 1 organization
I20080428000381 FL Practitioner - Family Practice 8022053263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1640 Crawfordsville Square Dr
Crawfordsville, IN 47933-3800
Phone (765) 362-5789

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS10246FLMDFamily Medicine Physician
02001804AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Family Medicine CurrentSince Jul 28, 2024 Accepting new patients
Phoenix American Medical LLC CurrentSince Dec 1, 2023 Accepting new patients
Pritesh & Tarak P a CurrentSince Sep 1, 2020 Accepting new patients
Franciscan Physician Network CurrentSince Jul 28, 2024 Accepting new patients
Indianapolis Osteopathic Hospital Inc. Family Medicine Past Accepting new patients
North Okaloosa Clinic Corp Family Medicine PastSince Sep 7, 2012 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients
Northwest Florida Primary Care LLC Past Accepting new patients
Patel Surgery LLC PastSince Dec 1, 2024 Accepting new patients

Locations

18928 N Dale Mabry Hwy
Ste 101
Lutz, FL 33548
Phone (813) 909-1146

8623 Regency Park Blvd
Port Richey, FL 34668
Phone (727) 842-9861

14690 Spring Hill Dr
Ste 101
Spring Hill, FL 34609

14690 Spring Hill Dr
Ste 305
Spring Hill, FL 34609
Phone (352) 277-5348

1030 S 78th St
Tampa, FL 33619
Phone (813) 740-0635

13305 N 56th St
Tampa, FL 33617
Phone (813) 988-1101

6719 Gall Blvd
Ste 206
Zephyrhills, FL 33542
Phone (813) 708-6990

1640 Crawfordsville Square Dr
Crawfordsville, IN 47933
Phone (765) 359-1113

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCACBD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1184638868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482783833",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 CRAWFORDSVILLE SQUARE DR",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479333800",
            "telephone_number": "765-362-5789",
            "fax_number": "765-362-2453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3480 Deltona Blvd",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "FL",
            "postal_code": "346062917",
            "country_code": "US",
            "telephone_number": "352-600-7900",
            "fax_number": "352-600-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5429 Commercial Way",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "FL",
            "postal_code": "346061110",
            "country_code": "US",
            "telephone_number": "352-600-4390",
            "fax_number": "352-600-4394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5446 Land O Lakes Blvd",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346393413",
            "country_code": "US",
            "telephone_number": "813-461-7180",
            "fax_number": "813-461-7182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6719 Gall Blvd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335422569",
            "country_code": "US",
            "telephone_number": "813-708-6990",
            "fax_number": "813-537-8762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIEND",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10246",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001804A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000371599",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280728900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14150",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01368092",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000891732",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200528320",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201246920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5517084",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordsville, IN

Sources for this page

Verify at the official NPI Registry.