Active NPI
Charles Scott Pursley, D.O.
- Family Medicine Physician
- Warren, MI
National Provider Identifier
1265634091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101007375
- Practice address
- 21500 Mound Road
Warren, MI 48091-2992 - Phone
- (586) 497-2256
- NPI assigned
- Jun 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101007375 | MI | Primary |
Addresses
Primary practice location
21500 Mound Road
Warren, MI 48091-2992
Mailing address
3170 Stanton Rd
Oxford, MI 48371-5829
Phone (248) 814-0234
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007375 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265634091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 STANTON RD",
"city": "OXFORD",
"state": "MI",
"postal_code": "483715829",
"telephone_number": "248-814-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21500 MOUND ROAD",
"city": "WARREN",
"state": "MI",
"postal_code": "480912992",
"telephone_number": "586-497-2256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURSLEY",
"first_name": "CHARLES",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101007375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.