Individual provider Active NPI

Charles Allen Preston, MD

  • Emergency Medicine Physician
  • Slidell, LA
National Provider Identifier
1639287659
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
018284 Issued in LA
Practice address
985 Robert Blvd
Suite 101
Slidell, LA 70458-2063
Phone
(985) 960-8300
Fax
(985) 690-8301
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 018284 LA Primary

Addresses

Primary practice location

985 Robert Blvd
Suite 101
Slidell, LA 70458-2063

Mailing address

985 Robert Blvd
Ste 101
Slidell, LA 70458-2063
Phone (985) 690-8300

Other identifiers 2

IdentifierTypeStateIssuer
1444570MedicaidLA
G5067OtherLABCBS LA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100617000728 LA Practitioner - Emergency Medicine 6709916117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018284LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Medical Center Past Accepting new patients
Ear, Nose, Throat Clinic of Slidell PastSince Dec 1, 2002 Accepting new patients
Van Meter MD & Associates Past Accepting new patients
ER Professional Fee Billing C/O Slidell Memorial Hospital Past Accepting new patients

Organizations & group practices 4

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1639287659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD",
            "address_2": "STE 101",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582063",
            "telephone_number": "985-690-8300",
            "fax_number": "985-847-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD",
            "address_2": "SUITE 101",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582063",
            "telephone_number": "985-960-8300",
            "fax_number": "985-690-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "018284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1444570",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LA",
            "identifier": "G5067",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.