NPIMap

Organization Active NPI

Charles L. Spellman, DO

  • Internal Medicine Physician
  • W Long Branch, NJ
National Provider Identifier
1619082922
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MB06409700 Issued in NJ
Legal business name
CHARLES L. SPELLMAN, DO
Practice address
842 Broadway
W Long Branch, NJ 07764-1503
Phone
(732) 269-2684
Fax
(732) 269-3963
NPI assigned
Aug 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Charles L Spellman, DONPI 1932187895
Title
Owner
Phone
(732) 269-3963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MB06409700 NJ Primary

Addresses

Primary practice location

842 Broadway
W Long Branch, NJ 07764-1503

Mailing address

842 Broadway
W Long Branch, NJ 07764-1503
Phone (732) 269-2684

National Provider Directory

National Provider Directory

Locations

300 2nd Ave
Ste W217
Long Branch, NJ 07740
Phone (732) 923-6696

842 Broadway
West Long Branch, NJ 07764
Phone (732) 222-0180

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619082922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 BROADWAY",
            "city": "W LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641503",
            "telephone_number": "732-269-2684",
            "fax_number": "732-269-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 BROADWAY",
            "city": "W LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641503",
            "telephone_number": "732-269-2684",
            "fax_number": "732-269-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L. SPELLMAN, DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPELLMAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-269-3963",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB06409700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.