Charles J Latendresse, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21831 Issued in IA

Practice address

1506 G Ave
Grundy Center, IA 50638-1038

Phone

(319) 824-3181

Fax

(319) 824-6680

NPI assigned

Sep 30, 2005

Last updated

Oct 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Unitypoint Health - Marshalltown

  • Emergency Medicine Physician
  • Marshalltown, IA
  • NPI 1164957593
  Medicare reassignment NPD
• Charles J Latendresse

  • Family Medicine Physician
  • Grundy Center, IA
  • NPI 1407030513
  Authorized official Same address or phone
• Salahuddin Syed MD PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Marshalltown, IA
  • NPI 1083054464
  NPD
• Unitypoint Health - Marshalltown

  dba Unitypoint Clinic - Family Medicine - Rohlf Memorial

  • Rural Health Clinic/Center
  • Waverly, IA
  • NPI 1124655006
  NPD
• Center for Behavioral Health

  • Psychologist
  • Waterloo, IA
  • NPI 1992904700
  NPD (past)
• Crystal Inc

  dba Westbrook Acres

  • Skilled Nursing Facility
  • Gladbrook, IA
  • NPI 1447334487
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1245227743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 G AVE",
            "address_2": "PO BOX 128",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506381038",
            "telephone_number": "319-824-3181",
            "fax_number": "319-824-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 G AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506381038",
            "telephone_number": "319-824-3181",
            "fax_number": "319-824-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATENDRESSE",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "21831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jansen Optical
• John Robert Jansen
• John Allen Jensen Sr., R.PH.
• Julie Johnson, PSYD, LMHC
• Frank Lee Lamp, M.D.
• David Lyman, DDS
• McCoy Psychological Services
• Brittney Ann Miller
• Eric Mitchell Neverman, D.O.
• Northland Hearing Centers, Inc. (Hearing Unlimited)

• Family Medicine Physician in Grundy Center, IA
• Providers in Grundy Center, 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 Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.