Individual provider Active NPI

Charles Ludeke Loredo, D.O.

  • Family Medicine Physician
  • Flint, MI
National Provider Identifier
1427249408
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101017345 Issued in MI
Practice address
102 W Pierson Rd
Flint, MI 48505-3348
Phone
(810) 222-3033
Fax
(810) 407-5729
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101017345 MI Primary

Addresses

Primary practice location

102 W Pierson Rd
Flint, MI 48505-3348

Mailing address

PO Box 746723
Atlanta, GA 30374-6723
Phone (312) 733-9730

Other practice location 1

18610 Fenkell St
Detroit, MI 48223-2378
Phone (313) 723-6000

Other practice location 2

11260 E Jefferson Ave
Detroit, MI 48214-3320
Phone (313) 749-0148

Other practice location 3

3525 Saginaw Rd
Burton, MI 48529
Phone (810) 222-3040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100927000978 MI Practitioner - Family Practice 4981720026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

11260 E Jefferson Ave
Jefferson Village Clinic
Detroit, MI 48214-3320
Phone (313) 749-0148

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Mi Physicians Group PC Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cloredo240446@direct.hfhs.org

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1427249408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746723",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W PIERSON RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485053348",
            "telephone_number": "810-222-3033",
            "fax_number": "810-407-5729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18610 Fenkell St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482232378",
            "country_code": "US",
            "telephone_number": "313-723-6000",
            "fax_number": "313-424-4058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11260 E Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482143320",
            "country_code": "US",
            "telephone_number": "313-749-0148",
            "fax_number": "313-263-3298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3525 Saginaw Rd",
            "address_purpose": "LOCATION",
            "city": "Burton",
            "state": "MI",
            "postal_code": "48529",
            "country_code": "US",
            "telephone_number": "810-222-3040",
            "fax_number": "810-958-1176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOREDO",
        "first_name": "CHARLES",
        "middle_name": "LUDEKE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101017345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.