Active NPI
Charles C Carter MD DPH PLLC
- Family Medicine Physician
- Altus, OK
National Provider Identifier
1326095381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 19154
- Legal business name
- CHARLES C CARTER MD DPH PLLC
- Practice address
- 1015 E Broadway St
Suite 102
Altus, OK 73521 - Phone
- (580) 480-1600
- Fax
- (580) 480-1601
- NPI assigned
- May 27, 2006
- Last updated
- Apr 5, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Charles C Carter, MD DPH
- Title
- Owner Physician
- Phone
- (580) 480-1600
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19154 | OK | Primary |
| Rural Health Clinic/Center | 261QR1300X |
Addresses
Primary practice location
1015 E Broadway St
Suite 102
Altus, OK 73521
Mailing address
PO Box 575
Altus, OK 73522-0575
Phone (580) 480-1600
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19154 | Other | OK | OK STATE LICENSE # |
| 100116810D | Medicaid | OK | |
| 100116810E | Medicaid | OK | |
| 203705843 | Other | OK | TRICARE/HUMANA PROVIDER # |
| C-8500 | Other | AR | ARKANSAS STATE LICENSE # |
| 37D1053611 | Other | OK | CLIA WAIVED |
| 445440041004 | Other | OK | BCBS BILLING # |
| 200113300A | Medicaid | OK |
Other names 1
- Charles C Carter MD DPh
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Altus, OK
- NPI 1730129750
-
- Family Nurse Practitioner
- Altus, OK
- NPI 1356824411
-
- Family Nurse Practitioner
- Altus, OK
- NPI 1437516788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649116800000",
"number": "1326095381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 575",
"city": "ALTUS",
"state": "OK",
"postal_code": "735220575",
"telephone_number": "580-480-1600",
"fax_number": "580-480-1601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 E BROADWAY ST",
"address_2": "SUITE 102",
"city": "ALTUS",
"state": "OK",
"postal_code": "73521",
"telephone_number": "580-480-1600",
"fax_number": "580-480-1601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLES C CARTER MD DPH PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-27",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A",
"authorized_official_last_name": "CARTER",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER PHYSICIAN",
"authorized_official_telephone_number": "580-480-1600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD DPH"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "19154",
"primary": true
},
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OK STATE LICENSE #",
"identifier": "19154",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100116810D",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100116810E",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE/HUMANA PROVIDER #",
"identifier": "203705843",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS STATE LICENSE #",
"identifier": "C-8500",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA WAIVED",
"identifier": "37D1053611",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BILLING #",
"identifier": "445440041004",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200113300A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Charles C Carter MD DPh",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Charles C Carter MD DPh",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Altus, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.