Charles B Vernon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24257 Issued in IA

Practice address

1791 Highway 64 E
Anamosa, IA 52205-2112

Phone

(319) 462-3571

Fax

(319) 462-6043

NPI assigned

Jan 3, 2006

Last updated

May 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1225016009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-3571",
            "fax_number": "319-462-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-3571",
            "fax_number": "319-462-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "CHARLES",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "24257",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IA",
            "license": "24257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019570",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225016009",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080116811",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Anamosa, IA
• Providers in Anamosa, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.