Charles Welke, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

384 Issued in ND

Practice address

3535 S 31St St Ste 201
Grand Forks, ND 58201-3593

Phone

(701) 780-6821

Fax

(701) 780-1973

NPI assigned

Apr 25, 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 3

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Assessment and Therapy Associates of Grand Forks PLLCGroup PAC ID 9436152626, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Assessment and Therapy Associates of Grand Forks, PLLC

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1437181591

  ND

  Medicare reassignment Care Compare group NPD
• Center for Psychiatric Care

  • Psychiatry Physician
  • Grand Forks, ND
  • NPI 1043271885

  Psychologist

  NPD (past)
• Bannock Inpatient Services PLLC

  • Emergency Medicine Physician
  • Pocatello, ID
  • NPI 1770948465
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1790741999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELKE",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BC/BS",
            "identifier": "26420",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13679",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BC/BS",
            "identifier": "298P6WE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chislaine Mariah Weisz, BSW
• Darianna Welch
• Welcore Health
• Welcore Health, LLC
• Welcore Health,LLC
• Darci Wendeborn
• Comfort Mungho Wendi
• Johanna E Wenninger Acosta, MD
• Laura Anne Wentz, NNP-BC
• Christopher John Werkley, MSW, LICSW, BCD

• All providers in Grand Forks, ND
• Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.