Charles Mark Homra, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME72122 Issued in FL

Practice address

710 Lomax St
Jacksonville, FL 32204-4004

Phone

(904) 355-6583

Fax

(904) 355-4922

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charleshomra@miuc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Physician Specialists LLC

  • Radiation Oncology Physician
  • Jacksonville, FL
  • NPI 1588917108
  Medicare reassignment NPD
• Florida Physician Specialists LLC

  • Radiation Oncology Physician
  • Jacksonville, FL
  • NPI 1033544390
  NPD
• McIver Urological Clinic

  • Urology Physician
  • Jacksonville, FL
  • NPI 1922063924
  NPD
• Mohamed H Antar MD PA

  • Urology Physician
  • Jacksonville, FL
  • NPI 1225197916
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1316088107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044004",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044004",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMRA",
        "first_name": "CHARLES",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME72122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251501600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Homecare Dimensions of Florida Inc.
• Homegrown Communication-SLP, LLC
• Barbara Homer, RN
• Hometolab Diagnostic Services LLC
• Hometown Pharmacy 1 LLC (HomeTowne Pharmacy)
• Heather Ashley Homrighouse, PA-C
• Amber Lynn Honaker, ARNP
• Justin Honaker
• Thalia L Honea, OTR/L
• Honeysett Acupuncture

• Urology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.