Individual provider Active NPI

Charlie G Joslin, MD

  • Family Medicine Physician
  • Ellinwood, KS
National Provider Identifier
1831172733
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0422818 Issued in KS
Practice address
300 N Park Ave
Ellinwood, KS 67526-1452
Phone
(620) 564-2548
Fax
(620) 564-2684
NPI assigned
Nov 23, 2005
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0422818 KS Primary

Addresses

Primary practice location

300 N Park Ave
Ellinwood, KS 67526-1452

Mailing address

300 N Park Ave
Ellinwood, KS 67526-1452
Phone (620) 564-2548

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040420001063 KS Practitioner - Family Practice 2365437035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains of Ellinwood IncGroup PAC ID 5092627539, shared by 3 NPIs, 13 clinicians

Practice addresses (Care Compare)

300 N Park Ave
Ellinwood, KS 67526-1452

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0422818KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains of Ellinwood Inc. CurrentSince Dec 1, 2009 Accepting new patients
Great Plains of Ellinwood, Inc. CurrentSince Dec 1, 2009 Accepting new patients
Great Plains of Ellinwood Inc. CurrentSince Jul 15, 2024 Accepting new patients
West Central Kansas Association, Inc. Past Accepting new patients

Locations

300 N Park Ave
Ellinwood, KS 67526
Phone (620) 564-2548

611 N Main St
Ellinwood, KS 67526
Phone (316) 564-3771

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1831172733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N PARK AVE",
            "city": "ELLINWOOD",
            "state": "KS",
            "postal_code": "675261452",
            "telephone_number": "620-564-2548",
            "fax_number": "620-564-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N PARK AVE",
            "city": "ELLINWOOD",
            "state": "KS",
            "postal_code": "675261452",
            "telephone_number": "620-564-2548",
            "fax_number": "620-564-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSLIN",
        "first_name": "CHARLIE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0422818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellinwood, KS

Sources for this page

Verify at the official NPI Registry.