Matthew Charles

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2013037719 Issued in MO

Practice address

10004 Kennerly Rd
Ste 364B
Saint Louis, MO 63128-2141

Phone

(314) 525-4429

Fax

(314) 525-7260

NPI assigned

Nov 22, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, IL, TX3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenbrook TMS St Louis LLCGroup PAC ID 4284985417, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.charles.1@18773.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 and National Provider Directory roles.

• Greenbrook TMS St Louis, LLC

  • Psychiatry Physician
  • Chesterfield, MO
  • NPI 1144713884
  Medicare reassignment Care Compare group
• Mercy East Support Services, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1225382013
  Medicare reassignment NPD
• TMS Neurohealth Illinois PLLC

  • Psychiatry Physician
  • Fairview Heights, IL
  • NPI 1386292571
  Medicare reassignment NPD
• TMS Neurohealth Texas PLLC

  • Psychiatry Physician
  • Austin, TX
  • NPI 1154892230
  Medicare reassignment NPD
• Emamefe Okinedo DMD PLLC

  • Dentist
  • Richmond, TX
  • NPI 1629846878
  NPD (past)

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1770913089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "STE 364B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-525-4429",
            "fax_number": "314-525-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "STE 364B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-525-4429",
            "fax_number": "314-525-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-22",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MO",
            "license": "2013037719",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2013037719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770913089",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin James Charles, AGNP
• Brigette Charles, LPC
• Claudia Charles, M.A., L.C.S.W.
• Eden Charles, MD
• Joel Claude Charles
• Miles Charles
• Patrick Charlier
• Charlies Angels Care LLC CDS
• Christopher Charlot, MD
• Rachel L Charney, MD

• Psychiatric/Mental Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.