NPIMap

Individual provider Active NPI

Charles J. Arnold Jr., M.D.

  • Family Medicine Physician
  • Winchester, KY
National Provider Identifier
1508203266
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49480 Issued in KY
Practice address
225 Hospital Dr Ste 105
Winchester, KY 40391-7624
Phone
(859) 744-2485
Fax
(859) 744-0062
NPI assigned
Jun 4, 2013
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49480 KY Primary
Internal Medicine Physician 207R00000X 49480 KY

Addresses

Primary practice location

225 Hospital Dr Ste 105
Winchester, KY 40391-7624

Mailing address

120 Professional Ave
Winchester, KY 40391-1116
Phone (859) 744-2485

Other identifiers 1

IdentifierTypeStateIssuer
7100430140MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161027002357 KY Practitioner - Family PracticePractitioner - Internal Medicine 6406134329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arnold HealingGroup PAC ID 2062897861, 2 clinicians

Practice addresses (Care Compare)

225 Hospital Dr
Suite 105
Winchester, KY 40391-7624
Phone (859) 428-7709

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue632
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49480KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnold Healing Family Medicine CurrentSince Jun 15, 2022 Accepting new patients
Clark Regional Physician Practices LLC CurrentSince Oct 1, 2016 Accepting new patients
Clark Regional Physician Practices LLC CurrentSince Oct 1, 2016 Accepting new patients

Locations

120 Professional Ave
Winchester, KY 40391
Phone (859) 744-2485

225 Hospital Dr
Winchester, KY 40391
Phone (859) 737-8528

225 Hospital Dr
Bldg A
Winchester, KY 40391
Phone (859) 428-7709

225 Hospital Dr
Ste 105
Winchester, KY 40391
Phone (859) 428-7709

225 Hospital Dr
Ste 200A
Winchester, KY 40391
Phone (859) 737-6480

Interoperability endpoints

  • Direct secure messaging: charles.arnold.1@19475.direct.athenahealth.com
  • Direct secure messaging: pso7509@yourcarecommunity.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1508203266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911116",
            "telephone_number": "859-744-2485",
            "fax_number": "859-744-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HOSPITAL DR STE 105",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403917624",
            "telephone_number": "859-744-2485",
            "fax_number": "859-744-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "CHARLES",
        "middle_name": "J.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "49480",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "49480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100430140",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

Verify at the official NPI Registry.