Charles J Ross, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

5809 Ivanhoe CT Apt 18
Fayetteville, NC 28314-4461

Phone

(253) 381-7108

NPI assigned

Apr 21, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1699919795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 IVANHOE CT APT 18",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283144461",
            "telephone_number": "253-381-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5809 IVANHOE CT APT 18",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283144461",
            "telephone_number": "253-381-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samisha Tankeyia Rose
• Shannon Rose
• Carl Willis Rosenberg, LMFT
• Jennifer L Rosenthal-Dibb, MS CCC-SLP
• Amanda K Ross, LCSWA
• Jerlinda Gladys Camille Ross, M.D.
• Karen Ross
• Karlishia Shenay Ross
• Kellie Michelle Ross, LCAS
• Melissa Marlene Ross, M.ED, CF- SLP

• Independent Duty Medical Technicians in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Independent Duty Medical Technicians in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.