NPIMap

Individual provider Active NPI

Kevin Michael Charron, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Carrollton, GA
National Provider Identifier
1699898437
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
060247 Issued in GA
Practice address
150 Clinic Ave
Ste 101
Carrollton, GA 30117-4401
Phone
(770) 834-0873
Fax
(770) 834-6118
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 44931 CO
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 060247 GA Primary

Addresses

Primary practice location

150 Clinic Ave
Ste 101
Carrollton, GA 30117-4401

Mailing address

150 Clinic Ave
Ste 101
Carrollton, GA 30117-4401
Phone (770) 834-0873

Other identifiers 1

IdentifierTypeStateIssuer
659167311BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000048 GA Practitioner - Orthopedic Surgery 9931278116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Medical Branch at Galveston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrollton Orthopaedic Clinic PCGroup PAC ID 7810989183, 31 clinicians

Practice addresses (Care Compare)

1124 N Park St
Suite M
Carrollton, GA 30117-2282
Phone (770) 834-0873

150 Clinic Ave
Carrollton, GA 30117-4498
Phone (770) 834-0873

150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401

150 Clinic Ave
Suite 101
Carrollton, GA 30117-4402

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44931COMDSports Medicine (Orthopaedic Surgery) Physician
060247GAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollton Orthopaedic Clinic PC Sports Medicine CurrentSince Sep 1, 2007 Accepting new patients

Locations

204 Allen Memorial Dr
Ste 102
Bremen, GA 30110
Phone (727) 755-0679

150 Clinic Ave
Ste 101
Carrollton, GA 30117
Phone (770) 834-0873

150 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-0873

705 Dallas Hwy
Ste 301
Villa Rica, GA 30180
Phone (770) 456-0211

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 6

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1699898437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE",
            "address_2": "STE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174401",
            "telephone_number": "770-834-0873",
            "fax_number": "770-834-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE",
            "address_2": "STE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174401",
            "telephone_number": "770-834-0873",
            "fax_number": "770-834-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARRON",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "44931",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "060247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "659167311B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.