Individual provider Active NPI

Charles B Dinwiddie Jr., MD

  • Internal Medicine Physician
  • Muncie, IN
National Provider Identifier
1477526200
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1033750 Issued in IN
Practice address
3700 N Everbrook LN
Muncie, IN 47304-5269
Phone
(765) 288-8577
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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 1033750 IN Primary

Addresses

Primary practice location

3700 N Everbrook LN
Muncie, IN 47304-5269

Mailing address

3700 N Everbrook LN
Muncie, IN 47304-5269
Phone (765) 288-8577

Other identifiers 1

IdentifierTypeStateIssuer
100106630AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100510000401 IN Practitioner - Internal Medicine 1557499779 Practice locations: Muncie, IN

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Therapy IncGroup PAC ID 6507893187, 81 clinicians

Practice addresses (Care Compare)

3607 N Everbrook LN
Muncie, IN 47304-5220

3700 N Everbrook LN
Muncie, IN 47304-4269
Phone (765) 288-8577

3700 N Everbrook LN
Muncie, IN 47304-5269

Hospital & facility affiliations

  • Elara Caring Home health agency, Fort Wayne, IN, CCN 157243
  • Hoosier Homecare Services LLC Home health agency, Anderson, IN, CCN 157608
  • Centerwell Home Health Home health agency, Muncie, IN, CCN 157180
  • Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1033750INMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glaucoma Center Inc 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.

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1477526200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 N EVERBROOK LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045269",
            "telephone_number": "765-288-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N EVERBROOK LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045269",
            "telephone_number": "765-288-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINWIDDIE",
        "first_name": "CHARLES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "1033750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106630A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.