Charlie M. Agee, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

14236 Issued in AZ

Practice address

9201 W Thomas Rd
Phoenix, AZ 85037-3332

Phone

(623) 327-5002

Fax

(623) 327-7184

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396867065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373332",
            "telephone_number": "623-327-5002",
            "fax_number": "623-327-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373332",
            "telephone_number": "623-327-5002",
            "fax_number": "623-327-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGEE",
        "first_name": "CHARLIE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "14236",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G52172",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agave Physician Services LLC
• Agave Postpartum Wellness Clinic PLLC
• Agave Surgery Center
• Agave Therapeutics PLLC
• Agavia LLC
• Loran Agee
• Ageless Health Institute, PC
• Ageless Nutrition Bar Holdings, Inc
• Jacqueline Lea Agenbroad, NP
• Michelle Elaine Ageno, M.S.,R.D.

• All providers in Phoenix, AZ
• Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.