Charles Gordon Borba

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

118 Maple Ave
Bellefontaine, OH 43311-1619

Phone

(937) 599-1975

Fax

(937) 599-2769

NPI assigned

Apr 24, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Consolidated Care Inc

  • Mental Health Counselor
  • West Liberty, OH
  • NPI 1215933569

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1497243620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433570817",
            "telephone_number": "937-465-8065",
            "fax_number": "937-465-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAPLE AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433111619",
            "telephone_number": "937-599-1975",
            "fax_number": "937-599-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORBA",
        "first_name": "CHARLES",
        "middle_name": "GORDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbey Lynn Bensman, RDLD
• Jody Lynn Bindas
• Bio-Medical Applications of Ohio, Inc.
• Chadwick Boberg, CNP
• Deborah Jean Bodenmiller
• Daniel William Boy, DDS
• Edwin Harold Boy, D.D.S.
• Jessamyn Bradley, LDO
• Kristen Theobald Braig, MD
• Allie Rose Branham

• Case Manager/Care Coordinator in Bellefontaine, OH
• Providers in Bellefontaine, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.