Individual provider Active NPI

Charles Thomas Canterbury, HMCS - NAVY IDC

  • Independent Duty Corpsman
  • Camp Lejeune, NC
National Provider Identifier
1225005515
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
Second Medical Battalion, 2D Marine Logistics Group
PSC Box 20129
Camp Lejeune, NC 28542-0129
Phone
(910) 450-7492
NPI assigned
Mar 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

Second Medical Battalion, 2D Marine Logistics Group
PSC Box 20129
Camp Lejeune, NC 28542-0129

Mailing address

Second Medical Battalion, 2D Marine Logistics Group
PSC Box 20129
Camp Lejeune, NC 28542-0129
Phone (910) 450-7492

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

NPI Registry JSON

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

{
    "created_epoch": "1141516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1225005515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SECOND MEDICAL BATTALION, 2D MARINE LOGISTICS GROUP",
            "address_2": "PSC BOX 20129",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420129",
            "telephone_number": "910-450-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SECOND MEDICAL BATTALION, 2D MARINE LOGISTICS GROUP",
            "address_2": "PSC BOX 20129",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420129",
            "telephone_number": "910-450-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERBURY",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "credential": "HMCS - NAVY IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-05",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.