Individual provider Active NPI

Charles L Gillum, AUD.

  • Audiologist
  • Manhattan, KS
National Provider Identifier
1407933583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
368 Issued in KS
Practice address
1213 Hylton Heights Rd
Sutie 105
Manhattan, KS 66502-2810
Phone
(785) 537-4005
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 368 KS Primary

Addresses

Primary practice location

1213 Hylton Heights Rd
Sutie 105
Manhattan, KS 66502-2810

Mailing address

1213 Hylton Heights Rd
Sutie 105
Manhattan, KS 66502-2810
Phone (785) 537-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Center Inc Audiologist PastSince Oct 23, 2000 Accepting new patients
Hearing Doctors of North America LLC Audiologist PastSince Oct 15, 2008 Accepting new patients

Organizations & group practices 2

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407933583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 HYLTON HEIGHTS RD",
            "address_2": "SUTIE 105",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022810",
            "telephone_number": "785-537-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 HYLTON HEIGHTS RD",
            "address_2": "SUTIE 105",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022810",
            "telephone_number": "785-537-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLUM",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "AUD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KS",
            "license": "368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

  • 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.