Individual provider Active NPI

Charles Edward Wingate Jr., M.D.

  • Ophthalmology Physician
  • Nashua, NH
National Provider Identifier
1619972015
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
5133 Issued in NH
Practice address
5 Coliseum Ave
Nashua, NH 03063-3292
Phone
(603) 882-9800
Fax
(603) 882-0556
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 5133 NH Primary
Ophthalmology Physician 207W00000X 57575 MA
Ophthalmology Physician 207W00000X D5253 TX

Addresses

Primary practice location

5 Coliseum Ave
Nashua, NH 03063-3292

Mailing address

5 Coliseum Ave
Nashua, NH 03063-3292
Phone (603) 882-9800

Other identifiers 1

IdentifierTypeStateIssuer
82183971MedicaidNH

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 Medicine

State licenses

LicenseStateTypeSpecialty
57575MAMDOphthalmology Physician
5133NHMDOphthalmology Physician
D5253TXMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1619972015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGATE",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NH",
            "license": "5133",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "57575",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "D5253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82183971",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.