Charles A Bagwell, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

050494 Issued in GA

Practice address

100 Doctors Dr Ste C
Douglas, GA 31533-2211

Phone

(912) 384-5832

Fax

(912) 383-8279

NPI assigned

Feb 22, 2006

Last updated

Mar 7, 2023By 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

Medicare fee-for-service enrollment

Enrolled in GA

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

General Surgery

Education

Medical College of Georgia School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee Regional Medical Center IncGroup PAC ID 4587656012, 29 clinicians

Coffee Emergency Group LLCGroup PAC ID 4880834050, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Coffee Emergency Group LLC

  • Emergency Medicine Physician
  • Douglas, GA
  • NPI 1023353489
  Medicare reassignment Care Compare group NPD
• Coffee Regional Medical Center, Inc

  • Anesthesiology Physician
  • Douglas, GA
  • NPI 1437120946
  Medicare reassignment Care Compare group NPD
• Coffee Regional Medical Center, Inc

  dba Coffee Regional First Care

  • Rural Health Clinic/Center
  • Douglas, GA
  • NPI 1639211956
  NPD
• CRH Physician Practices LLC

  dba CRH Surgical Group

  • Surgery Physician
  • Waycross, GA
  • NPI 1154794857
  NPD (past)
• CRH Physician Practices, LLC

  dba CRH Urology Clinic

  • Urology Physician
  • Douglas, GA
  • NPI 1306359781
  NPD (past)

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

• Coffee Regional Medical Center, Inc

  dba Coffee Regional Medical Center

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366417479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WARD STREET EXT W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315331902",
            "telephone_number": "912-384-1477",
            "fax_number": "912-384-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE C",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-384-5832",
            "fax_number": "912-383-8279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 E 15th St",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "GA",
            "postal_code": "315102908",
            "country_code": "US",
            "telephone_number": "912-384-5832",
            "fax_number": "912-383-8279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "050494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asf Medical Center Inc
• Sara E Atkinson, LCSW
• Lovelle Waydia Auguste, M.D.
• Stephen John Augustine, D.O.
• Austin Respiratory and Medical Equipment Inc
• Sherry Bailey, FNP-C
• Manish Kumar Bansal, MD
• Akhil Baranwal, MD
• James William Barber, MD
• Lisa A Batten, NP

• Surgery Physician in Douglas, GA
• Providers in Douglas, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.