Charles Ray Alderdice, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101008526 Issued in MI

Practice address

1906 Langley Ave
Saint Joseph, MI 49085-1739

Phone

(269) 982-1722

Fax

(269) 982-1842

NPI assigned

May 2, 2006

Last updated

Jul 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• C R Alderdice D O

  • Family Medicine Physician
  • Saint Joseph, MI
  • NPI 1972807147
  NPD (past) Authorized official

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1821056649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 LANGLEY AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851739",
            "telephone_number": "269-982-1722",
            "fax_number": "269-982-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 LANGLEY AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851739",
            "telephone_number": "269-982-1722",
            "fax_number": "269-982-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDERDICE",
        "first_name": "CHARLES",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.