NPIMap

Individual provider Active NPI

Charles Raymond Nolan III, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Seguin, TX
National Provider Identifier
1467463893
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
J3175 Issued in TX
Practice address
1215 East Court Street
Guadalupe Regional Medical Center
Seguin, TX 78155
Phone
(830) 401-7561
Fax
(830) 379-4441
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X J3175 TX Primary
Nephrology Physician 207RN0300X J3175 TX

Addresses

Primary practice location

1215 East Court Street
Guadalupe Regional Medical Center
Seguin, TX 78155

Mailing address

1215 E Court St
Guadalupe Regional Hospice Services
Seguin, TX 78155-5129
Phone (830) 401-7561

Other identifiers 1

IdentifierTypeStateIssuer
046605404MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090617000241 TX Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Nephrology 6800946682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
University of Colorado School of Medicine, Denver, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guadalupe County Hospital BoardGroup PAC ID 5496653842, 31 clinicians

Practice addresses (Care Compare)

1215 E Court St
Seguin, TX 78155-5129
Phone (830) 379-2411

Hospital & facility affiliations

  • Guadalupe Regional Hospice Hospice, Seguin, TX, CCN 451541
  • Guadalupe Regional Medical Center Hospital, Seguin, TX, CCN 450104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guadalupe Regional Medical Group CurrentSince Aug 4, 2014 Accepting new patients
Guadalupe County Hospital Board CurrentSince Oct 1, 2018 Accepting new patients
Guadalupe County Hospital Board Current Accepting new patients
Guadalupe County Hospital Board CurrentSince Oct 1, 2018 Accepting new patients
Guadalupe County Hospital Board Current Accepting new patients
Guadalupe Regional Medical Group CurrentSince Aug 4, 2014 Accepting new patients
Guadalupe County Hospital Board Current Accepting new patients
Guadalupe County Hospital Board Past Accepting new patients

Locations

1215 E Court St
Seguin, TX 78155
Phone (830) 379-2411

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27064/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1467463893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "address_2": "GUADALUPE REGIONAL HOSPICE SERVICES",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-401-7561",
            "fax_number": "830-379-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EAST COURT STREET",
            "address_2": "GUADALUPE REGIONAL MEDICAL CENTER",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "78155",
            "telephone_number": "830-401-7561",
            "fax_number": "830-379-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "J3175",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "J3175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046605404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.