Charles Scott Adler, PA-C
Individual provider Active NPI Physician Assistant · Springfield, MO
NPI 1487950127 · NPPES record last updated Feb 4, 2013
Key facts
- NPI
- 1487950127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2011003916 (MO)
- Practice address
- 3801 S National Ave
5TH Floor
Springfield, MO 65807-5210 - Phone
- (417) 269-7728
- Fax
- (417) 269-7729
- NPI assigned
- Jan 27, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110425000446 | MO | Practitioner - Physician Assistant | 4082899745 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1097328 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Memorial Healthcare | Current |
Accepting new patients | |
| Citizens Memorial Healthcare | Physician Assistant | Current |
Accepting new patients |
| North Arkansas Regional Medical Center | Past | Accepting new patients | |
| Skaggs Community Hospital Association | Past | Accepting new patients |
Locations
1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1097328 | MO | |
| Physician Assistant | 363A00000X | 2011003916 | MO | Yes |
Addresses
Primary practice location
3801 S National Ave
5TH Floor
Springfield, MO 65807-5210
Mailing address
PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-7728
Other providers in Springfield, MO
- Ridwan O Adepoju
- Oluwadamilola Adetayo
- Jacqueline Adkins
- Ryan K. Adkins
- Brian Wilson Adkison
- Maggie Adler
- Admiral Dermatology LLC
- Ads Springfield East LP
- Ads Springfield West LP
- Adult Medicine of the Ozarks, LLC
All providers in Springfield, MO · Physician Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.