Charles Walter Patterson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010589 Issued in AZ

Practice address

2876 N Pinal Ave Ste 4
Casa Grande, AZ 85122-7944

Phone

(520) 374-2225

Fax

(520) 374-2229

NPI assigned

Dec 22, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 22, 2015 through Sep 22, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpatterson242212@direct.valleywisehealth.org

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.

• Villago Dentistry LLC

  • General Practice Dentistry
  • Casa Grande, AZ
  • NPI 1780226464
  NPD
• Villago Marketplace Dental Care PC

  • General Practice Dentistry
  • Casa Grande, AZ
  • NPI 1639333479
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1508842410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CHAMBERLAIN LN UNIT 209",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409289",
            "telephone_number": "630-210-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2876 N PINAL AVE STE 4",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851227944",
            "telephone_number": "520-374-2225",
            "fax_number": "520-374-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "CHARLES",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "D010589",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dayaljibhai D. Patel, M.D.
• Nidhi A Patel, DMD
• Hemali Paton, PHARM.D.
• Analiah Mahinalani Patrice, ND
• Justin Joseph Pattee, D.O.
• Paul T Wilson OD PC
• Christopher Pavero, PHARMD
• PC Pain Doctors, PLLC
• Peace Homes LLC
• Ronald David Peacock Jr., PT, DPT

• General Practice Dentistry in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.