Individual provider Active NPI

Charles A Rosenthal, O.D.

  • Optometrist
  • Chattanooga, TN
National Provider Identifier
1801014840
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT000783 Issued in TN
Practice address
2040 Hamilton Place Blvd Ste 400
Chattanooga, TN 37421
Phone
(423) 499-3737
Fax
(423) 499-4277
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT000783 TN Primary

Addresses

Primary practice location

2040 Hamilton Place Blvd Ste 400
Chattanooga, TN 37421

Mailing address

718 Hurricane Creek Rd
Chattanooga, TN 37421-4514
Phone (423) 499-3737

Other practice location 1

525 Kimball Crossing
Walmart Vision Center
Kimball, TN 37347
Phone (423) 837-1849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ODT000783TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1801014840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 HURRICANE CREEK RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214514",
            "telephone_number": "423-499-3737",
            "fax_number": "423-499-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 HAMILTON PLACE BLVD STE 400",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-499-3737",
            "fax_number": "423-499-4277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 KIMBALL CROSSING",
            "address_2": "WALMART VISION CENTER",
            "address_purpose": "LOCATION",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "37347",
            "country_code": "US",
            "telephone_number": "423-837-1849",
            "fax_number": "423-499-4277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT000783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.