NPIMap

Individual provider Active NPI

Charles S Edenfield, M.D.

  • Internal Medicine Physician
  • Warner Robins, GA
National Provider Identifier
1467492785
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
030052 Issued in GA
Practice address
623 S Houston Lake Rd Ste 200
Warner Robins, GA 31088-9094
Phone
(478) 923-6633
Fax
(478) 923-8444
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 030052 GA Primary

Addresses

Primary practice location

623 S Houston Lake Rd Ste 200
Warner Robins, GA 31088-9094

Mailing address

2675 Winkler Ave Ste 200
Fort Myers, FL 33901-9328
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
00354362DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100324000784 GA Practitioner - Internal MedicinePractitioner - Pulmonary Disease 9436285822 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group of Georgia LLCGroup PAC ID 9638699648, 31 clinicians

Practice addresses (Care Compare)

623 S Houston Lake Rd
Suite 200
Warner Robins, GA 31088-9094
Phone (478) 923-6633

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group of Georgia LLC Internal Medicine CurrentSince Apr 20, 2026 Accepting new patients
Houston Hospitals Inc CurrentSince Dec 19, 2009 Accepting new patients
Middle Georgia Medical Associates, P.C. Internal Medicine CurrentSince Aug 1, 1997 Accepting new patients
Houston Hospitals Inc CurrentSince Dec 19, 2009 Accepting new patients

Locations

623 S Houston Lake Rd
Ste 200
Warner Robins, GA 31088
Phone (478) 923-4403

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

1601 Watson Blvd
Ste 140B
Warner Robins, GA 31093
Phone (478) 922-4281

Interoperability endpoints

  • Direct secure messaging: csedenfieldmd@04426f10.micromddirect.com

Organizations & group practices 4

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 8

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1467492785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019328",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S HOUSTON LAKE RD STE 200",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889094",
            "telephone_number": "478-923-6633",
            "fax_number": "478-923-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENFIELD",
        "first_name": "CHARLES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "030052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354362D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.