Charles H. Fraga, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

25053 Issued in MS

Practice address

4250 Bethel Rd
Olive Branch, MS 38654-8737

Phone

(901) 516-1290

Fax

(901) 516-1220

NPI assigned

Apr 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cfraga24058@mlh.direct-ci.com

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.

• Methodist Inpatient Physicians LLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1609850692

  MS

  Medicare reassignment NPD
• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101
  Medicare reassignment

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1487097002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BETHEL RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "262 Danny Thomas Place, MS#810",
            "address_2": "St. Jude Children's Research Hospital",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38105",
            "country_code": "US",
            "telephone_number": "901-595-2340",
            "fax_number": "901-595-0912",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7691 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383904",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAGA",
        "first_name": "CHARLES",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "55513",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "25053",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "MD55513",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "25053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manessha Teneal Floyd
• Dallis Glenn Forsythe, DPT
• Michael E. Foster, M.D.
• Four Winds Counseling and Consulting
• Latrice Fox Dillard
• Galisa Franklin, CP
• Gerianna Kneeland Frazier, MS, NCC, LPC-MHSP
• Sarah Lynn Freed, D.P.M.
• William Anthony Frost, PHARMD
• Emily Jean Frye

• Hospitalist Physician in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Hospitalist Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.