Individual provider Active NPI

Charles D. Hodges Jr., M.D.

  • Family Medicine Physician
  • Avon, IN
National Provider Identifier
1487641163
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01026260 Issued in IN
Practice address
8244 E US Highway 36 Ste 1100
Avon, IN 46123-9627
Phone
(317) 272-7500
Fax
(317) 272-7515
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01026260 IN Primary

Addresses

Primary practice location

8244 E US Highway 36 Ste 1100
Avon, IN 46123-9627

Mailing address

429 N Pennsylvania St
Suite 400
Indianapolis, IN 46204-1815
Phone (317) 791-6691

Other identifiers 1

IdentifierTypeStateIssuer
100217690AMedicaidIN

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
I20080305000323 IN Practitioner - Family Practice 2567547268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

1001 Broad Ripple Ave
Indianapolis, IN 46220-2093
Phone (317) 338-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01026260INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Group Inc Past Accepting new patients
Hendricks County Hospital Family Medicine Past Accepting new patients
Major Hospital Past Accepting new patients
St. Francis Hospital and Health Centers Family Medicine Past Accepting new patients
St. Francis Medical Group, LLC Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: charles.hodges.1@7598.direct.athenahealth.com

Organizations & group practices 6

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1487641163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 N PENNSYLVANIA ST",
            "address_2": "SUITE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041815",
            "telephone_number": "317-791-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36 STE 1100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239627",
            "telephone_number": "317-272-7500",
            "fax_number": "317-272-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "CHARLES",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01026260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100217690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.