Charles J Alexis, M.D

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

15773 Issued in PR

Practice address

921 NE 13TH St
Oklahoma City, OK 73104-5007

Phone

(405) 270-0501

Fax

(405) 290-1887

NPI assigned

Oct 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMP Southland, LLCGroup PAC ID 1153563770, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelin.alexis.1@25580.direct.athenahealth.com

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.

• SGMP Southland LLC

  • Psychiatry Physician
  • Valdosta, GA
  • NPI 1447695085
  Medicare reassignment Care Compare group NPD
• Greenleaf Center, LLC

  dba Greenleaf Behavioral Health Hospital

  • Psychiatric Hospital
  • Valdosta, GA
  • NPI 1538417753
  Medicare reassignment NPD
• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469
  NPD
• Hospital Authority of Valdosta and Lowndes County, Georgia

  • Ambulance
  • Valdosta, GA
  • NPI 1558141671
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730260084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7348 EDENBOROUGH DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731325616",
            "telephone_number": "405-270-0501",
            "fax_number": "405-290-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045007",
            "telephone_number": "405-270-0501",
            "fax_number": "405-290-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXIS",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "PR",
            "license": "15773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPOYE IDENTIFICATION NUM",
            "identifier": "77948",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stuart Wayne Alexander, PT
• Tamara Taylor Alexander, M.D.
• Vickie Alexander, MS (LPC)
• Willis Ulysses Alexander Jr.
• Zakkiyya Alexander
• Justina R Alfonso, ARNP
• Niahna Bobbi Alford-Hamer
• Jenellis Alford
• Marquiz Alford, M.ED
• Teresa Ann Alford, MA

• Geriatric Psychiatry Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Geriatric Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.