NPIMap

Individual provider Active NPI

Charles Allen Hare, PA-C

  • Physician Assistant
  • Del Rio, TX
National Provider Identifier
1508995309
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03738 Issued in TX
Practice address
1117 W de la Rosa St
Del Rio, TX 78840-6224
Phone
(830) 768-4800
Fax
(830) 768-4844
NPI assigned
Mar 5, 2007
Last updated
Oct 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03738 TX Primary

Addresses

Primary practice location

1117 W de la Rosa St
Del Rio, TX 78840-6224

Mailing address

PO Box 1470
Eagle Pass, TX 78853-1470
Phone (830) 773-6963

Other identifiers 1

IdentifierTypeStateIssuer
PA03738OtherTXPHYSICIAN ASSTANT ID

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03738TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midland County Hospital District Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Odessa Physician Associates, PLLC Physician Assistant Past Accepting new patients
Martin County Hospital District Past Accepting new patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
Martin County Hospital District Past Accepting new patients
Valley Emergency Physicians Past Accepting new patients
Third Coast Emergency Physicians Sid Peterson PA Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Camino Real Emergency Physicians PLLC Physician Assistant Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1508995309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1470",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788531470",
            "telephone_number": "830-773-6963",
            "fax_number": "830-757-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 W DE LA ROSA ST",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788406224",
            "telephone_number": "830-768-4800",
            "fax_number": "830-768-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARE",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSTANT ID",
            "identifier": "PA03738",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Rio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.