Individual provider Active NPI

Charlotte Halkiades, NP

  • Gerontology Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1639573025
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
901830 Issued in MS
Practice address
4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone
(901) 516-1290
Fax
(901) 516-1220
NPI assigned
Oct 15, 2014
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 18744 TN
Gerontology Nurse Practitioner 363LG0600X 901830 MS Primary

Addresses

Primary practice location

4250 Bethel Rd
Olive Branch, MS 38654-8737

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190613000650 MS Practitioner - Nurse Practitioner 1052644606 Reassigns benefits to 1 organization
I20191125000793 TN Practitioner - Nurse Practitioner 1052644606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians

Practice addresses (Care Compare)

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-1290

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Inpatient Physicians LLC CurrentSince Jun 24, 2019 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Interoperability endpoints

  • Direct secure messaging: chalkiades24152@mlh.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1639573025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BETHEL RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7691 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383904",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALKIADES",
        "first_name": "CHARLOTTE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "18744",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "901830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.