Charles Andrew Mosimbwa, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301089193 Issued in MI

Practice address

16 E Main St
Niles, MI 49120-2200

Phone

(269) 683-7411

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Goodhope Medical Group

  • Contractor
  • Berrien Springs, MI
  • NPI 1851699870
  NPD (past) Authorized official
• Lake Region Medical Center, P.C.

  • Family Medicine Physician
  • Berrien Springs, MI
  • NPI 1912105602
  NPD (past) Authorized official

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1215134408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 E MAIN ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202200",
            "telephone_number": "269-683-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E MAIN ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202200",
            "telephone_number": "269-683-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSIMBWA",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301089193",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301089193",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Ashley Monnin, LLMSW
• Cicely Moreno, M.D.
• Lee Morris
• Jessica Morse, COMMUNITY HEALTH WOR
• Saundra L Mortenson, LCSW
• Estelle Gladys Moss
• Triphonie Mukampunga, RN
• Meghan K. Murphy, D.O.
• Patrick John Murphy, LMSW
• Catherine Murr, NP

• Internal Medicine Physician in Niles, MI
• Providers in Niles, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.