Charles Louis McCall Jr., MD
Individual provider Active NPI Diagnostic Radiology Physician · Jackson, TN
NPI 1659310316 · NPPES record last updated Jan 10, 2017
Key facts
- NPI
- 1659310316
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 15620 (TN)
- Practice address
- 367 Hospital Blvd
Jackson, TN 38305-2080 - Phone
- (731) 661-2000
- Fax
- (901) 753-2896
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Louisiana State University School of Medicine in New Orleans, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Radiology P C
Practice addresses (Care Compare)
150 Bertrand Dr
Franklin, TN 37064-8308
Phone (260) 432-1568
17 Deepwood Dr
Jackson, TN 38305-9678
Phone (260) 432-1568
Hospital & facility affiliations
- Lutheran Hospital of Indiana
- The Orthopaedic Hospital of Lutheran Health Networ
- Dupont Hospital LLC
- St Joseph Health System, LLC
- Ascension St Vincent Clay
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.96 of 100
- Quality
- 92.18
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040325001307 | TN | Practitioner - Diagnostic Radiology | 2668364696 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49780 | KY | MD | Diagnostic Radiology Physician |
| 15620 | TN | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Radiology P C | Diagnostic Radiology | Current |
Accepting new patients |
| Bolivar General Hospital, Inc. | Past | Accepting new patients | |
| Independent Radiology Associates PLC | Diagnostic Radiology | Past | Accepting new patients |
| Advanced Radiology PC | Diagnostic Radiology | Past | Accepting new patients |
| Jackson Clinic PA | Past | Accepting new patients | |
| Radiology Associates of Oxford - PA | Diagnostic Radiology | Past | Accepting new patients |
| University Radiology at Buffalo, Inc. | Diagnostic Radiology | Past | Accepting new patients |
| Radcare of Tennessee PC | Diagnostic Radiology | Past | Accepting new patients |
| Vista Radiology, PC. | Diagnostic Radiology | Past | Accepting new patients |
| Bolivar General Hospital, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 15620 | TN | Yes |
| Diagnostic Radiology Physician | 2085R0202X | TP388 | KY | |
| Diagnostic Radiology Physician | 2085R0202X | 49780 | KY |
Addresses
Primary practice location
367 Hospital Blvd
Jackson, TN 38305-2080
Mailing address
791 Walnut Knoll LN
2ND FL
Cordova, TN 38018-8839
Phone (901) 755-7001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3038448 | Medicaid | TN |
Other providers in Jackson, TN
- Twellia Latise McAlpin
- Gary McBride
- Laurie L. McBride
- Julie A McBroom
- Ellen Dedmon McCadams
- Jennifer Warren McCarter
- Micah Lee McCarty
- Maria Elizabeth McCaskill
- Nicholas McClary
- Shelby Kate McCord
All providers in Jackson, TN · Diagnostic Radiology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.