Active NPI
Charles Leonard Lett Sr., M.D.
- Surgery Physician
- Selma, AL
National Provider Identifier
1437233186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 8713
- Practice address
- 1013 Medical Center Pkwy
Building 1 Suite a
Selma, AL 36701-6742 - Phone
- (334) 875-4374
- Fax
- (334) 875-4340
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 8713 | AL | Primary |
Addresses
Primary practice location
1013 Medical Center Pkwy
Building 1 Suite a
Selma, AL 36701-6742
Mailing address
1013 Medical Center Pkwy
Building 1 Suite a
Selma, AL 36701-6742
Phone (334) 875-4374
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51002287 | Other | AL | BLUE CROSS |
| 5299248030 | Medicaid | AL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8713 | AL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Selma, Inc | Past | Accepting new patients | |
| Pilcher McBryde Drug Company | Past | 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.
-
- Durable Medical Equipment & Medical Supplies
- Selma, AL
- NPI 1801899463
-
- Federally Qualified Health Center (FQHC)
- Selma, AL
- NPI 1831190263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1437233186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 MEDICAL CENTER PKWY",
"address_2": "BUILDING 1 SUITE A",
"city": "SELMA",
"state": "AL",
"postal_code": "367016742",
"telephone_number": "334-875-4374",
"fax_number": "334-875-4340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 MEDICAL CENTER PKWY",
"address_2": "BUILDING 1 SUITE A",
"city": "SELMA",
"state": "AL",
"postal_code": "367016742",
"telephone_number": "334-875-4374",
"fax_number": "334-875-4340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LETT",
"first_name": "CHARLES",
"middle_name": "LEONARD",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AL",
"license": "8713",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "51002287",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5299248030",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selma, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.