Individual provider Active NPI

Charles William Briles, PHD

  • Psychologist
  • Tucson, AZ
National Provider Identifier
1508917279
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1609 Issued in AZ
Practice address
350 N Wilmot Rd
Tucson, AZ 85711-2678
Phone
(520) 873-3495
Fax
(520) 873-5162
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1609 AZ Primary

Addresses

Primary practice location

350 N Wilmot Rd
Tucson, AZ 85711-2678

Mailing address

350 N Wilmot Rd
Tucson, AZ 85711-2678
Phone (520) 873-3495

Other identifiers 1

IdentifierTypeStateIssuer
020321MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carondelet Specialist Group, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1508917279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112678",
            "telephone_number": "520-873-3495",
            "fax_number": "520-873-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112678",
            "telephone_number": "520-873-3495",
            "fax_number": "520-873-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRILES",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "1609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020321",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.