Charles D Jarboe, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22717 Issued in KY

Practice address

912 Wallace Ave
Suite 103
Leitchfield, KY 42754-2404

Phone

(270) 230-8200

Fax

(270) 230-0882

NPI assigned

Jul 6, 2005

Reactivated

Mar 28, 2006

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 5

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Kentucky College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concord Company of Tennessee PLLCGroup PAC ID 0345588109, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Owensboro Health Twin Lakes Medical Center Hospital, Leitchfield, KY, CCN 180070

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 and National Provider Directory roles.

• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667
  Medicare reassignment Care Compare group
• Elizabethtown Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Elizabethtown, KY
  • NPI 1528003316
  NPD (past)
• Green River Emergency Physicians

  • Emergency Medicine Physician
  • Bowling Green, KY
  • NPI 1336393438
  NPD (past)
• Kentucky Em-I Medical Services PSC

  • Nurse Practitioner
  • Bowling Green, KY
  • NPI 1083869135
  NPD (past)
• Marshall Emergency Services Associates, PLLC

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1891737185
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Owensboro Health Twin Lakes Regional Medical Center, Inc

  dba Owensboro Health Twin Lakes Medical Center

  • General Acute Care Hospital
  • Leitchfield, KY
  • NPI 1285221416
  Care Compare affiliation

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356348213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WALLACE AVE STE 103",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542405",
            "telephone_number": "270-230-8200",
            "fax_number": "270-230-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALLACE AVE",
            "address_2": "SUITE 103",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542404",
            "telephone_number": "270-230-8200",
            "fax_number": "270-230-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARBOE",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2007-07-09",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "22717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN #",
            "identifier": "000000222830",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH UNIVERSAL CREDENTIAL",
            "identifier": "10804168",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "320012117",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "18D0999959",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64227176",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Rachelle Hyberger, LPA
• Lydia Jackson, RBT
• Jeanette Marie Jacobs, APRN
• Jarboe Family Practice, PSC
• Allyson D Jarboe
• Andrew William Jenkins, M.D.
• Cari Beth Johnson, APRN, FNP-BC
• Craig Arby Johnson, M.D.
• Shannon Lea Johnston, LPCC
• Andrea Leigh Kemp, MS CCC-SLP

• Family Medicine Physician in Leitchfield, KY
• Providers in Leitchfield, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.