Active NPI
Charlie Andrew Tacito
- Land Ambulance
- Memphis, TN
National Provider Identifier
1215086731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- EMS0000010018
- Practice address
- 1684 Poplar Ave
Memphis, TN 38104 - Phone
- (901) 278-1616
- Fax
- (901) 278-0144
- NPI assigned
- Jan 10, 2007
- Last updated
- Apr 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | EMS0000010018 | TN | Primary |
Addresses
Primary practice location
1684 Poplar Ave
Memphis, TN 38104
Mailing address
PO Box 77
Marion, AR 72364
Phone (901) 278-1616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EMS0000010018 | TN | MD | Land Ambulance |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1215086731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 77",
"city": "MARION",
"state": "AR",
"postal_code": "72364",
"telephone_number": "901-278-1616",
"fax_number": "901-278-0144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1684 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-278-1616",
"fax_number": "901-278-0144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACITO",
"first_name": "CHARLIE",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "TN",
"license": "EMS0000010018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.