Individual provider Active NPI

Charles Edward Pexa, MD

  • Emergency Medicine Physician
  • Aiken, SC
National Provider Identifier
1467550103
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21800 Issued in MN
Practice address
326 Hopeland Farm Dr
Aiken, SC 29803-9082
Phone
(803) 642-5937
NPI assigned
Sep 20, 2006
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35906 SC
Emergency Medicine Physician 207P00000X 21800 MN Primary

Addresses

Primary practice location

326 Hopeland Farm Dr
Aiken, SC 29803-9082

Mailing address

326 Hopeland Farm Dr
Aiken, SC 29803-9082
Phone (803) 642-5937

Other identifiers 1

IdentifierTypeStateIssuer
365705100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150715001819 SC Practitioner - Emergency Medicine 9133013782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21800MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

1029 York St NE
Aiken, SC 29801
Phone (803) 502-1484

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

Interoperability endpoints

  • Direct secure messaging: charles.pexa.1@18348.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1467550103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 HOPELAND FARM DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298039082",
            "telephone_number": "803-642-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 HOPELAND FARM DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298039082",
            "telephone_number": "803-642-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEXA",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "35906",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "21800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365705100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.