Individual provider Active NPI

Charles D Anderson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Norman, OK
National Provider Identifier
1790779890
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
190 Issued in OK
Practice address
817 24TH Ave NW
Norman, OK 73069-6313
Phone
(405) 360-9338
Fax
(405) 366-1669
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 190 OK Primary

Addresses

Primary practice location

817 24TH Ave NW
Norman, OK 73069-6313

Mailing address

817 24TH Ave NW
Norman, OK 73069-6313
Phone (405) 360-9338

Other practice location 1

415 W Guy Ave
Pauls Valley, OK 73075-3200
Phone (405) 329-3929

Other identifiers 1

IdentifierTypeStateIssuer
100779900AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000717 OK Practitioner - Podiatry 0143389817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

817 24TH Ave NW
Norman Office
Norman, OK 73069-6313
Phone (405) 329-3929

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue51
Removal of nail tissue736
Removal or shaving of skin growth100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
190OKMDRecreation Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Foot & Ankle Clinic PC Foot & Ankle Surgery CurrentSince Oct 1, 2008 Accepting new patients
Denise L. Rable, M.D., P.C. Past Accepting new patients

Locations

817 24th Ave NW
Norman, OK 73069
Phone (405) 329-3929

817 24th Ave NW
Ofc
Norman, OK 73069
Phone (405) 329-3929

500 E Robinson St
Ste 500
Norman, OK 73071
Phone (405) 329-5857

415 W Guy Ave
Pauls Valley, OK 73075
Phone (405) 238-1170

Interoperability endpoints

  • Direct secure messaging: andersonfoot@aafcp-ok.direct.office.nextgen.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Surgical Hospital of OklahomaOklahoma City, OK, CCN 370201 Hospital Limited Partnership Interest (0.79%) Apr 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790779890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 24TH AVE NW",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696313",
            "telephone_number": "405-360-9338",
            "fax_number": "405-366-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 24TH AVE NW",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696313",
            "telephone_number": "405-360-9338",
            "fax_number": "405-366-1669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 W Guy Ave",
            "address_purpose": "LOCATION",
            "city": "Pauls Valley",
            "state": "OK",
            "postal_code": "730753200",
            "country_code": "US",
            "telephone_number": "405-329-3929",
            "fax_number": "405-366-1669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100779900A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.