Charles Ted Mettetal, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F6042 Issued in TX

Practice address

801 W Main St
Gun Barrel City, TX 75156-5312

Phone

(903) 887-1011

Fax

(903) 603-9441

NPI assigned

Jun 16, 2005

Last updated

May 6, 2024By 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 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Community Clinic IncGroup PAC ID 3678902905, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bristol Hospice - North Central Texas Hospice, Waxahachie, TX, CCN 451743
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• East Texas Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gun Barrel City, TX
  • NPI 1033752456

  Family Medicine

  Medicare reassignment Care Compare group NPD
• East Texas Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Canton, TX
  • NPI 1497568513
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Bristol Hospice - Pathways LLC

  dba Bristol Hospice - North Central Texas

  • Community Based Hospice Care Agency
  • Waxahachie, TX
  • NPI 1568710358
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1245235266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1610",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-603-7067",
            "fax_number": "903-603-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAIN ST",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751565312",
            "telephone_number": "903-887-1011",
            "fax_number": "903-603-9441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 MEDICAL CIRCLE",
            "address_purpose": "LOCATION",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "75751",
            "country_code": "US",
            "telephone_number": "903-676-3200",
            "fax_number": "903-676-3277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METTETAL",
        "first_name": "CHARLES",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2024-05-06",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F6042",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C4956",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133097901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80F795",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asiya Mahmood, M.D
• Gregory Scott Marshall, D.D.S.
• Veronique Matthews, DMD
• Nicole Matus, FNP
• Susan C McMullen, M.D.
• Shannon Middleton, APRN
• Midwife Jolene PLLC
• Emily Lauren Miller
• Miracles From Heaven Midwifery PLLC (The Birth Suite)
• Wilson Darell Murphy, MD

• Family Medicine Physician in Gun Barrel City, TX
• Providers in Gun Barrel City, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.