Nesly Ismenard Charles, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10014 Issued in AZ

Practice address

3822 Broadway Ste a
Fort Myers, FL 33901-8148

Phone

(239) 900-9170

NPI assigned

Jul 10, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sante Plus Medical Center

  • Clinic/Center
  • Immokalee, FL
  • NPI 1407514904
  NPD (past)
• Sante Plus Medical Center

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1639759475

  Multi-Specialty

  NPD (past)
• Phandinh Clinic-Urgent Care & Wellness Center PC

  • Urgent Care Clinic/Center
  • Glendale, AZ
  • NPI 1093596876
  NPD (past)
• Phandinh Clinic-Urgent Care and Wellness Center PC

  • Primary Care Clinic/Center
  • Glendale, AZ
  • NPI 1588413827

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1700564846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SEA PINES WAY",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334624248",
            "telephone_number": "561-574-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 BROADWAY STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018148",
            "telephone_number": "239-900-9170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3155 Lake Worth Rd",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "FL",
            "postal_code": "334616917",
            "country_code": "US",
            "telephone_number": "561-858-8817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "NESLY",
        "middle_name": "ISMENARD",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "21-268",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles S Eby MD PA
• Charles V Klucka DO PA
• Erica Charles
• Liza N Charles, M.D
• Nelson Charles, M.D.
• Nicole E Charles, ARNP
• Patrick Harry Charles, NURSE PRACTITIONER
• Phares Charles, PA
• Kelly Lyn Chasnov
• Peggy Elizabeth Chatham, M.D.

• Medical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.