Active NPI
Todd J Charlesworth, PA C
- Medical Physician Assistant
- Bellingham, WA
National Provider Identifier
1346343274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10005145
- Practice address
- 2901 Squalicum Pkwy
Bellingham, WA 98225-1851 - Phone
- (360) 738-6765
- Fax
- (360) 738-6377
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10005145 | WA | Primary |
Addresses
Primary practice location
2901 Squalicum Pkwy
Bellingham, WA 98225-1851
Mailing address
1 Boone Rd
Bremerton, WA 98312-1894
Phone (425) 304-4160
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0218367 | Other | WA | LIWA |
| 5357CH | Other | WA | BSWA |
| 8474355 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Em-I Medical Services PC | Past | Accepting new patients | |
| Sedro Woolley Emergency Physicians | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Sedro Woolley, WA
- NPI 1548219785
-
- Emergency Medicine Physician
- Sedro Woolley, WA
- NPI 1457300691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1346343274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BOONE RD",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121894",
"telephone_number": "425-304-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 SQUALICUM PKWY",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251851",
"telephone_number": "360-738-6765",
"fax_number": "360-738-6377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLESWORTH",
"first_name": "TODD",
"middle_name": "J",
"credential": "PA C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10005145",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0218367",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "5357CH",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8474355",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.