NPIMap

Individual provider Active NPI

Charles Michael Littlejohn, MD

  • Internal Medicine Physician
  • Princeton, KY
National Provider Identifier
1831202738
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30506 Issued in KY
Practice address
320 Micbeth Dr
Princeton, KY 42445-6332
Phone
(270) 365-3343
Fax
(270) 365-1213
NPI assigned
Aug 16, 2006
Last updated
Mar 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30506 KY Primary

Addresses

Primary practice location

320 Micbeth Dr
Princeton, KY 42445-6332

Mailing address

PO Box 72
Princeton, KY 42445-0072
Phone (270) 365-3343

Other identifiers 1

IdentifierTypeStateIssuer
64305063MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000472 KY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3476605700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Louisville School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caldwell County Hospital, IncGroup PAC ID 0749275014, 25 clinicians

Practice addresses (Care Compare)

320 Micbeth Dr
Princeton, KY 42445-6332
Phone (270) 365-0320

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caldwell County Hospital, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Caldwell County Hospital, Inc Current Accepting new patients
Caldwell County Hospital, Inc CurrentSince Jan 1, 2019 Accepting new patients
Princeton Ky Opco LLC Past Accepting new patients
Caldwell County Hospital Inc Past Accepting new patients
Caldwell County Hospital, Inc Past Accepting new patients

Locations

100 Medical Center Dr
Princeton, KY 42445
Phone (270) 365-0300

302 Micbeth Dr
Princeton, KY 42445
Phone (270) 365-1225

320 Micbeth Dr
Princeton, KY 42445
Phone (270) 365-0320

Interoperability endpoints

  • Direct secure messaging: charles.littlejohn@caldmedassoc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GIDFCD

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Caldwell Medical CenterPrinceton, KY, CCN 181322 Hospital Corporate Director Jul 1, 2011
Caldwell Medical CenterPrinceton, KY, CCN 18Z322 Hospital Corporate Director Jul 1, 2011
Caldwell Medical AssociatesPrinceton, KY, CCN 188521 Rural health clinic Corporate Director Sep 1, 2018
Caldwell Medical AssociatesPrinceton, KY, CCN 188526 Rural health clinic Corporate Officer May 1, 2019
Caldwell Medical AssociatesFredonia, KY, CCN 188529 Rural health clinic Corporate Director Dec 1, 2019
Caldwell Medical AssociatesEddyville, KY, CCN 188568 Rural health clinic Corporate Director Jan 1, 2023

Owned or controlled facilities with NPI records 7

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

Organizations & group practices 7

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1831202738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424450072",
            "telephone_number": "270-365-3343",
            "fax_number": "270-365-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MICBETH DR",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424456332",
            "telephone_number": "270-365-3343",
            "fax_number": "270-365-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEJOHN",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "30506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64305063",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, KY

Sources for this page

Verify at the official NPI Registry.