Charles L Carr Jr DO PA

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

Legal business name

CHARLES L CARR JR DO PA

Practice address

4335 Cheval Blvd
Lutz, FL 33558-5328

Phone

(207) 332-0774

NPI assigned

Jan 9, 2020

Organization subpart

No

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

Authorized official

Name

Charles L Carr Jr., DO

Title

President

Phone

(207) 332-0774

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1649810540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 VAN DYKE RD # 259",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588025",
            "telephone_number": "207-332-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4335 CHEVAL BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585328",
            "telephone_number": "207-332-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L CARR JR DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-332-0774",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Fax machine",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Fax",
            "address_1": "4335 Cheval Blvd",
            "city": "Lutz",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335585328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• CG1 Chiropractic Clinic, Inc.
• John C Chan, M.D.
• Paula Chan, BCABA
• Yun Tae Chang, MD
• Chapman Manor at Lutz LLC
• Alice G Chase, LMHC
• Thuy-Van Chau, MD
• Juliana Chaves, APRN
• Xandus Chen, D.O.
• Dae Young Cheong, PT

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Lutz, FL
• Providers in Lutz, FL by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.