Individual provider Active NPI

Charlotta Z Langley, MD

  • Pediatrics Physician
  • Bradenton, FL
National Provider Identifier
1255440012
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME88696 Issued in FL
Practice address
1515 26TH Ave E
Bradenton, FL 34208-7707
Phone
(941) 708-8600
Fax
(941) 708-7645
NPI assigned
Aug 29, 2006
Last updated
Oct 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME88696 FL Primary

Addresses

Primary practice location

1515 26TH Ave E
Bradenton, FL 34208-7707

Mailing address

700 8TH Ave W Ste 101
Palmetto, FL 34221-4737
Phone (941) 776-4000

Other identifiers 2

IdentifierTypeStateIssuer
267969800MedicaidFL
33181OtherFLFLORIDA BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20040917000472 FL Practitioner - Pediatric Medicine 5890763973 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME88696FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerplace Health, Inc CurrentSince Aug 1, 2020 Accepting new patients
SMH Physician Services Inc Pediatrics CurrentSince Sep 28, 2015 Accepting new patients
The Nemours Foundation Past Accepting new patients
The Nemours Foundation Past Accepting new patients
MCR Health, Inc. Past Accepting new patients

Locations

8430 Enterprise Cir
Ste 130
Lakewood Ranch, FL 34202
Phone (941) 366-3000

2345 Bobcat Village Center Rd
Unit 201
North Port, FL 34288
Phone (941) 379-6331

6950 Outreach Way
North Port, FL 34287
Phone (941) 529-0200

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1750 17th St
Ste E
Sarasota, FL 34234
Phone (941) 529-0200

1750 17th St
Ste N
Sarasota, FL 34234
Phone (941) 529-0200

1900 Brother Geenen Way
Sarasota, FL 34236
Phone (941) 556-3215

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

2200 Ringling Blvd
Sarasota, FL 34237
Phone (941) 861-2900

Interoperability endpoints

  • Direct secure messaging: charlotta.langley.1@11352.direct.athenahealth.com
  • Direct secure messaging: charlotta.langley.1@16972.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1255440012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 26TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342087707",
            "telephone_number": "941-708-8600",
            "fax_number": "941-708-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLEY",
        "first_name": "CHARLOTTA",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME88696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267969800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "33181",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.