Charles Albert Tollett Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01042157 Issued in IN

Practice address

407 E 22ND St
Huntingburg, IN 47542-8964

Phone

(812) 683-6339

Fax

(812) 683-6337

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Deaconess Memorial Medical Center Inc

  • Rural Health Clinic/Center
  • French Lick, IN
  • NPI 1881843522
  Medicare reassignment
• Deaconess Memorial Medical Center Inc

  • Emergency Medicine Physician
  • Huntingburg, IN
  • NPI 1114120128
  NPD
• Deaconess Memorial Medical Center Inc

  • Family Medicine Physician
  • Santa Claus, IN
  • NPI 1295788362
  NPD
• Deaconess Memorial Medical Center Inc

  • Family Medicine Physician
  • Huntingburg, IN
  • NPI 1508054206

  Surgery

  NPD
• Deaconess Memorial Medical Center Inc

  • Hospitalist Physician
  • Jasper, IN
  • NPI 1588778518
  NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1497827356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 327",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475420327",
            "telephone_number": "812-683-6339",
            "fax_number": "812-683-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 22ND ST",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475428964",
            "telephone_number": "812-683-6339",
            "fax_number": "812-683-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLETT",
        "first_name": "CHARLES",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01042157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000238257",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004142200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan M Sutton, DPT
• Harry Louis Switzer, DDS
• The Huntingburg Clinic
• The Waters of Huntingburg, LLC
• The Wellness Center of Indiana, LLC
• Transition Home Health Services, LLC
• Transitional Services Sub, LLC
• Transitional Services, Inc
• Tretter Physical Therapy PC
• Theresa Lynn Tretter, P.T.

• Surgery Physician in Huntingburg, IN
• Providers in Huntingburg, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.