Charlotte B Vdovychenko

Primary specialty

Medical Laboratory TechnicianTaxonomy code 246RM2200X

License

4075 Issued in WI

Practice address

2801 Brazos Blvd
Apt 4309
Euless, TX 76039-5435

Phone

(817) 915-1800

Fax

(682) 503-6649

NPI assigned

Nov 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Charley Stanley Laboratories LLC

  • Clinical Medical Laboratory
  • Euless, TX
  • NPI 1093174898
  Authorized official Same address or phone
• Charlotte Vdovychenko

  dba Central Laboratory Services

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1992982151
  Authorized official Same address or phone

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1689829418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760390059",
            "telephone_number": "817-915-1800",
            "fax_number": "682-503-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BRAZOS BLVD",
            "address_2": "APT 4309",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760395435",
            "telephone_number": "817-915-1800",
            "fax_number": "682-503-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VDOVYCHENKO",
        "first_name": "CHARLOTTE",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "WI",
            "license": "4075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689829418",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brianna Vaught, BSN, RN, IBCLC
• Veda & Karthik Gorrepati PLLC (Pleasant Dental)
• Sameer Veerani, NP
• Viba Dental, PLLC
• Gurkiran Kaur Gulati Virdee, OD
• Vital Supply LLC

• Medical Laboratory Technician in Euless, TX
• Providers in Euless, TX by specialty
• Medical Laboratory Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.