Individual provider Active NPI

Charles Edward Parke, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
National Provider Identifier
1295759223
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
16601 Issued in SC
Practice address
105 Holbrook Trail
Greenville, SC 29605-3164
Phone
(864) 242-9666
Fax
(864) 240-6047
NPI assigned
Jul 26, 2006
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 00014743 AL
Diagnostic Radiology Physician 2085R0202X 2006-00770 NC
Diagnostic Radiology Physician 2085R0202X 057907 GA
Diagnostic Radiology Physician 2085R0202X 16601 SC Primary

Addresses

Primary practice location

105 Holbrook Trail
Greenville, SC 29605-3164

Mailing address

PO Box 52990
Greenwood, SC 29649-0048
Phone (843) 223-3600

Other practice location 1

4 Carriage Ln Ste 108
Charleston, SC 29407-6048
Phone (828) 430-3511

Other practice location 2

123 Wamsutta Mill Rd Ste C
Morganton, NC 28655-5521
Phone (828) 430-3511

Other practice location 3

125 Wamsutta Mill Rd Ste C
Morganton, NC 28655-5522
Phone (828) 430-3511

Other identifiers 1

IdentifierTypeStateIssuer
166019MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050818000952 SC Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9739119702 Reassigns benefits to 2 organizations
I20160606002187 NC Practitioner - Diagnostic Radiology 9739119702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Partners PLLCGroup PAC ID 1254654809, 9 clinicians

Practice addresses (Care Compare)

125 Wamsutta Mill Rd
Suite C
Morganton, NC 28655-5522
Phone (828) 430-3511

4 Carriage LN
Suite 108
Charleston, SC 29407-6048
Phone (828) 430-3511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00014743ALMDDiagnostic Radiology Physician
057907GAMDDiagnostic Radiology Physician
16601SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Dec 4, 2023 Accepting new patients
Sonocare, LLC CurrentSince Mar 23, 2016 Accepting new patients
Imaging Partners PLLC Diagnostic Radiology CurrentSince Mar 23, 2016 Accepting new patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Dec 4, 2023 Accepting new patients
Direct Diagnostic Services, LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

123 Wamsutta Mill Rd
Ste C
Morganton, NC 28655
Phone (828) 430-3051

125 Wamsutta Mill Rd
Ste B
Morganton, NC 28655

125 Wamsutta Mill Rd
Ste C
Morganton, NC 28655

127 Wamsutta Mill Rd
Ste D
Morganton, NC 28655
Phone 8284303511 ext. 104

4 Carriage Ln
Ste 108
Charleston, SC 29407
Phone (828) 396-5634

1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1295759223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52990",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490048",
            "telephone_number": "843-223-3600",
            "fax_number": "864-889-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HOLBROOK TRAIL",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296053164",
            "telephone_number": "864-242-9666",
            "fax_number": "864-240-6047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Carriage Ln Ste 108",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294076048",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Wamsutta Mill Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286555521",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Wamsutta Mill Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286555522",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKE",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "00014743",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2006-00770",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "057907",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "16601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.