Individual provider Active NPI

Charles E. Hare, M.S., CCCA

  • Audiologist
  • Independence, MO
National Provider Identifier
1811056989
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
102183 Issued in MO
Practice address
17020 E US Highway 40
Suite 9
Independence, MO 64055-5361
Phone
(816) 373-7900
Fax
(816) 373-7969
NPI assigned
Dec 6, 2006
Last updated
Jun 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 102183 MO Primary

Addresses

Primary practice location

17020 E US Highway 40
Suite 9
Independence, MO 64055-5361

Mailing address

17020 E US Highway 40
Suite 9
Independence, MO 64055-5361
Phone (816) 373-7900

Other identifiers 1

IdentifierTypeStateIssuer
19100061OtherMOBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040301000401 MO Practitioner - Qualified Audiologist 1153217252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
KC Hearing Center LLC Audiologist CurrentSince Jul 11, 2023 Accepting new patients

Locations

17020 E US Highway 40
Ste 9
Independence, MO 64055
Phone (816) 373-7900

6528 Raytown Rd
Ste I
Raytown, MO 64133
Phone (816) 353-3358

Interoperability endpoints

  • Direct secure messaging: charles.harem.s.ccc-a@direct.tmcmed.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1811056989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17020 E US HIGHWAY 40",
            "address_2": "SUITE 9",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555361",
            "telephone_number": "816-373-7900",
            "fax_number": "816-373-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17020 E US HIGHWAY 40",
            "address_2": "SUITE 9",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555361",
            "telephone_number": "816-373-7900",
            "fax_number": "816-373-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARE",
        "first_name": "CHARLES",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "M.S., CCCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "102183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "19100061",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.