Individual provider Active NPI

Charles Freeman McCluskey

  • Research Clinic/Center
  • Macon, GA
National Provider Identifier
1386371953
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Research Clinic/CenterTaxonomy code 261QR1100X
Practice address
1501 Mercer University Dr
Macon, GA 31207-1515
Phone
(706) 332-0051
NPI assigned
Aug 4, 2022
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Research Clinic/Center 261QR1100X Primary

Addresses

Primary practice location

1501 Mercer University Dr
Macon, GA 31207-1515

Mailing address

1501 Mercer University Dr
Macon, GA 31207-1515
Phone (706) 332-0051

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230721000150 GA Order and Referring Only - UrologyPractitioner - Urology 2264892363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1386371953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MERCER UNIVERSITY DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312071515",
            "telephone_number": "706-332-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MERCER UNIVERSITY DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312071515",
            "telephone_number": "706-332-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "CHARLES",
        "middle_name": "FREEMAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.