Individual provider Active NPI

Charles Edward Mays II, PA

  • Emergency Medicine Physician
  • Miramar Beach, FL
National Provider Identifier
1417909268
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PA9102401 Issued in FL
Practice address
7800 US Highway 98 W # ER
Emergency Room
Miramar Beach, FL 32550-7228
Phone
(850) 278-3000
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PA9102401 FL Primary

Addresses

Primary practice location

7800 US Highway 98 W # ER
Emergency Room
Miramar Beach, FL 32550-7228

Mailing address

PO Box 2699
SHMG/Hpe
Pensacola, FL 32513-2699
Phone (850) 475-4686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629001397 FL Practitioner - Physician Assistant 0840276788 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102401FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services LLC Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients
FL-I Medical Services LLC Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients
Vale of Paradise Emergency Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

Organizations & group practices 6

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1417909268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "SHMG/HPE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-475-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 US HIGHWAY 98 W # ER",
            "address_2": "EMERGENCY ROOM",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507228",
            "telephone_number": "850-278-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYS",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "PA9102401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar Beach, FL

Sources for this page

Verify at the official NPI Registry.