Charles Ross MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME96407 Issued in FL

Legal business name

CHARLES ROSS MD PA

Doing business as

MedEx Walk-In

Practice address

511 W Alexander St
Suite 1
Plant City, FL 33563-7116

Phone

(813) 719-7246

Fax

(813) 464-2781

NPI assigned

Oct 17, 2009

Last updated

Sep 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Ross, MD

Title

Owner

Phone

(813) 270-0325

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MedEx Walk-In Doing business as

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

{
    "created_epoch": "1255737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1194051623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 POWDER RIDGE DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944040",
            "telephone_number": "813-389-7582",
            "fax_number": "813-464-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W ALEXANDER ST",
            "address_2": "SUITE 1",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637116",
            "telephone_number": "813-719-7246",
            "fax_number": "813-464-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES ROSS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-17",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-270-0325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME96407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1461Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedEx Walk-In",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Plant City, FL
• Providers in Plant City, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.