Active NPI
Charles Mahoney, DO
- Student in an Organized Health Care Education/Training Program
- Warren, MI
National Provider Identifier
1376485003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 27450 Schoenherr Rd Ste 400
Warren, MI 48088-6684 - Phone
- (586) 582-7550
- Fax
- (586) 582-7515
- NPI assigned
- Apr 9, 2026
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
27450 Schoenherr Rd Ste 400
Warren, MI 48088-6684
Mailing address
27450 Schoenherr Rd Ste 400
Warren, MI 48088-6684
Phone (586) 582-7550
Other names 1
- Charlie Mahoney
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260518001677 | MI | Order and Referring Only - Family Practice | 5597234716 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775692800000",
"number": "1376485003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27450 SCHOENHERR RD STE 400",
"city": "WARREN",
"state": "MI",
"postal_code": "480886684",
"telephone_number": "586-582-7550",
"fax_number": "586-582-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27450 SCHOENHERR RD STE 400",
"city": "WARREN",
"state": "MI",
"postal_code": "480886684",
"telephone_number": "586-582-7550",
"fax_number": "586-582-7515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "CHARLES",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-09",
"last_updated": "2026-04-09",
"certification_date": "2026-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHARLIE",
"last_name": "MAHONEY",
"credential": "DO",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.