Charles W Page MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

K7468 Issued in TX

Legal business name

CHARLES W PAGE MD PA

Practice address

1320 N University Dr Ste a
Nacogdoches, TX 75961-4270

Phone

(936) 568-9600

Fax

(936) 568-9621

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles W Page, MDNPI 1437104585

Title

Owner

Phone

(936) 568-9600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17347/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Wade Page, M.D.

  • Specialist
  • Nacogdoches, TX
  • NPI 1437104585
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1306892872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 N UNIVERSITY DR STE A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614270",
            "telephone_number": "936-568-9600",
            "fax_number": "936-568-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N UNIVERSITY DR STE A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614270",
            "telephone_number": "936-568-9600",
            "fax_number": "936-568-9621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1018 N Mound St",
            "address_2": "SUITE 103",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759614492",
            "country_code": "US",
            "telephone_number": "936-568-9600",
            "fax_number": "936-568-9621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHARLES W PAGE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-568-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "K7468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "0005NL",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.