Charles Henley Medbery, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

04-28353 Issued in KS

Practice address

401 Woodland Hills Blvd
Fort Scott, KS 66701-8797

Phone

(620) 223-2200

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Overland Park Radiologists, PA

  • Diagnostic Radiology Physician
  • Fort Scott, KS
  • NPI 1255336251
  NPD (past)
• United Imaging Consultants, LLC

  • Diagnostic Radiology Physician
  • Lenexa, KS
  • NPI 1588669766
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1528063609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOXRIDGE DR",
            "address_2": "STE 240",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022338",
            "telephone_number": "913-261-3153",
            "fax_number": "913-262-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WOODLAND HILLS BLVD",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667018797",
            "telephone_number": "620-223-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDBERY",
        "first_name": "CHARLES",
        "middle_name": "HENLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-28353",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "107212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00173775",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100171060C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207821547",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lux Dental LLC
• Joy Noel Mapes, LMSW
• Max H Patterson DDS Chartered
• Matthew Clem McGhee, MS, LCPC
• Dana Marshall McKenney, ARNP
• Medicalodges, Inc.
• Medicalodges, Inc.
• Mercy Community Sevices Inc
• Mercy Health System of Kansas Inc.
• Mercy Kansas Communities Inc

• Diagnostic Radiology Physician in Fort Scott, KS
• Providers in Fort Scott, KS by specialty
• Diagnostic Radiology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.