Charles E Womack, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME88146 Issued in FL

Practice address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone

(386) 254-4199

Fax

(386) 947-4680

NPI assigned

Jan 18, 2007

Last updated

Apr 5, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Halifax Healthcare Systems Inc

  dba HHCSI Halifax Family Health Center

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Urology

  NPD (past)
• Holzer Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gallipolis, OH
  • NPI 1508817248
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1306999123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-254-4199",
            "fax_number": "386-947-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-254-4199",
            "fax_number": "386-947-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME88146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME88146",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277522100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karina Wold, PHARMD
• Hanna Woldeyes
• Amy Lynn Wolf, D.C.
• Keery L. Wolf, BCBA
• Beth Ann Womack, RDH
• Yu Ho Wong, M.D.,
• Austin Paul Woodman, RN
• Elizabeth Lynn Woods, ARNP
• Kristen Carla Woody, MD
• Karishma Workmon

• Urology Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; 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.