Individual provider Active NPI

Charles Mahoney, DO

  • Student in an Organized Health Care Education/Training Program
  • Warren, MI
National Provider Identifier
1376485003
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
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

Updated by the provider on Apr 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260518001677 MI Order and Referring Only - Family PracticePractitioner - 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

Verify at the official NPI Registry.