Charles Higgins Jr., RD CSR

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

1081333 Issued in AZ

Practice address

1601 E Highland Ave Apt 1082
Phoenix, AZ 85016-0609

Phone

(716) 425-2764

Fax

(602) 840-4445

NPI assigned

Sep 22, 2017

Last updated

Apr 12, 2021By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1285143115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E HIGHLAND AVE APT 1082",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160609",
            "telephone_number": "716-425-2764",
            "fax_number": "602-840-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E HIGHLAND AVE APT 1082",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160609",
            "telephone_number": "716-425-2764",
            "fax_number": "602-840-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINS",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RD CSR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "AZ",
            "license": "1081333",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "AZ",
            "license": "1081333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD CSR",
            "identifier": "1081333",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Lynn Higgins, NNP
• Beth A Higgins, M.S.
• Carissa Jo Higgins, MSN, PMHNP
• Carolyn F. Higgins, M.S. CCC-SLP
• Catherine Gail Higgins, LPN
• Hailey Higgins, CF-SLP
• Mackenzie Lee Higgins, MSW
• Meagan Suzanne Higgins, FNP
• Stephanie Loreen Higgins
• William H Higgins, D.O.

• Renal Nutrition Registered Dietitian in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Renal Nutrition Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.