Individual provider Active NPI

Gregory Alan Charlton, M.D.

  • Neurology Physician
  • Las Cruces, NM
National Provider Identifier
1386675270
Registry record updated Jul 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2001-154 Issued in NM
Practice address
1240 S Telshor Blvd
Suite B
Las Cruces, NM 88011-4731
Phone
(575) 522-3885
Fax
(575) 522-3895
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 2001-154 NM
Neurology Physician 2084N0400X 2001-154 NM Primary
Clinical Neurophysiology Physician 2084N0600X 2001-154 NM

Addresses

Primary practice location

1240 S Telshor Blvd
Suite B
Las Cruces, NM 88011-4731

Mailing address

1240 S Telshor Blvd
Suite B
Las Cruces, NM 88011-4731
Phone (575) 522-3885

Other identifiers 2

IdentifierTypeStateIssuer
68700041MedicaidNM
742785MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20070815000617 NM Practitioner - Neurology 6103718226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Wisconsin School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sleep Lab of Las Cruces LLCGroup PAC ID 1658695358, 3 clinicians

Practice addresses (Care Compare)

2437 S Telshor Blvd
Las Cruces, NM 88011-5049
Phone (575) 522-2777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Jan 26, 2021 Accepting new patients
Sleep Lab of Las Cruces LLC CurrentSince Sep 21, 2014 Accepting new patients
Otero County Hospital Association CurrentSince Jan 26, 2021 Accepting new patients
Gonzalo a Diaz Past Accepting new patients

Locations

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

2437 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-2777

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312070400000",
    "number": "1386675270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 S TELSHOR BLVD",
            "address_2": "SUITE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114731",
            "telephone_number": "575-522-3885",
            "fax_number": "575-522-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S TELSHOR BLVD",
            "address_2": "SUITE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114731",
            "telephone_number": "575-522-3885",
            "fax_number": "575-522-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NM",
            "license": "2001-154",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "2001-154",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NM",
            "license": "2001-154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68700041",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "742785",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.