NPIMap

Organization Active NPI

Charter Health PC

  • Internal Medicine Physician
  • Salem, MA
National Provider Identifier
1750824124
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
249997 Issued in MA
Legal business name
CHARTER HEALTH PC
Practice address
55 Highland Ave Ste 304
Salem, MA 01970-2100
Phone
(978) 354-4611
NPI assigned
Dec 2, 2016
Last updated
Dec 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Dr. Hans C Jeppesen, M.D.NPI 1669678298
Title
Ceo
Phone
(763) 350-6598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 249997 MA Primary

Addresses

Primary practice location

55 Highland Ave Ste 304
Salem, MA 01970-2100

Mailing address

55 Highland Ave Ste 304
Salem, MA 01970-2100
Phone (978) 354-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170220000311 MA Part B Supplier - Clinic/Group Practice 1153604079 Receives reassigned benefits from 82 practitioners
Practice locations: Salem, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2131340Charter Health, PC55 Highland Avenue, Salem, MA 01970Certificate of waiverMay 25, 2027

National Provider Directory

National Provider Directory

Locations

55 Fruit St
#7
Boston, MA 02114
Phone (617) 724-2241

496 Lynnfield St
Ste 104
Lynn, MA 01904
Phone (781) 586-9300

Interoperability endpoints

  • Direct secure messaging: appleton.jenya.ch@direct.partners.masshiway.net
  • Direct secure messaging: gafanhao.denise.ch@direct.partners.masshiway.net
  • Direct secure messaging: guenin.alla.ch@direct.partners.masshiway.net
  • Direct secure messaging: herron.katina.ch@direct.partners.masshiway.net
  • Direct secure messaging: jeppesen.hans.ch@direct.partners.masshiway.net
  • Direct secure messaging: nugent.samantha.ch@direct.partners.masshiway.net
  • Direct secure messaging: saini.gurpreet.ch@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 84

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1750824124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE STE 304",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-354-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE STE 304",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-354-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTER HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-02",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "JEPPESEN",
        "authorized_official_first_name": "HANS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-350-6598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "249997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.