Charles Jacob Stoudenmire, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

079906 Issued in GA

Practice address

507 W 3Rd Ave Ste 7
Albany, GA 31701

Phone

(615) 343-4882

NPI assigned

Apr 17, 2013

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

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

Pathology

Education

Medical College of Georgia School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SW Georgia Pathology AssociatesGroup PAC ID 2365435856, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• SW Georgia Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Albany, GA
  • NPI 1780727263
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Care Compare affiliation

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1750725099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 W 3RD AVE STE 7",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 W 3RD AVE STE 7",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "615-343-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUDENMIRE",
        "first_name": "CHARLES",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "079906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi S Stewart, NP
• Robert Lewis Stickle, MD
• Still Waters Case Management of Southwest Georgia
• Stephen Wayne Stocking, PA-C
• Lindon Storm
• Richard H Stowe Jr., PA-C
• Tsvetelina Nikolova Stoyanova
• Sheryl Angel Stoyle, FNP-C
• Monte D Strawder
• Samuel L Strickland, MD

• Anatomic Pathology & Clinical Pathology Physician in Albany, GA
• Providers in Albany, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.