Charles Mack Grubb, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03541 Issued in TX

Practice address

6750 N Macarthur Blvd Ste 350
Irving, TX 75039-2484

Phone

(972) 556-1616

Fax

(972) 556-1740

NPI assigned

Jun 12, 2006

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Clinic of North Texas, PLLCGroup PAC ID 9830084540, 212 clinicians

Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: charles.grubb@wellmed.eclinicaldirectplus.com

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.

• Medical Clinic of North Texas, PLLC

  • Internal Medicine Physician
  • Arlington, TX
  • NPI 1033167234

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486
  Medicare reassignment Care Compare group NPD
• Medical Clinic of North Texas PLLC

  • Radiation Oncology Clinic/Center
  • Arlington, TX
  • NPI 1184131625
  NPD
• Wellmed Medical Group, P.a.

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1366484354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 N MACARTHUR BLVD STE 350",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392484",
            "telephone_number": "972-556-1616",
            "fax_number": "972-556-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 N MACARTHUR BLVD STE 350",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392484",
            "telephone_number": "972-556-1616",
            "fax_number": "972-556-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBB",
        "first_name": "CHARLES",
        "middle_name": "MACK",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebanie Griffith
• Lyric Mauree Grissom I, PTA
• Antoine Gross Sr., LPC
• Leonard Gross, MD
• Erik Robert Grossman, MD
• Charlotte Gruber, LCSW
• David Lee Gruber, DDS
• Gruh Medical PLLC
• Emily Robin Gruver, M.S.
• Guadalup Rehab and Pain Center PA

• Physician Assistant in Irving, TX
• Providers in Irving, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.