Individual provider Active NPI

Charles Stephen Houston, M.D.

  • Diagnostic Radiology Physician
  • Leesburg, FL
National Provider Identifier
1841249869
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME88925 Issued in FL
Practice address
801 E Dixie Ave
Suite 104
Leesburg, FL 34748-7601
Phone
(352) 365-2583
Fax
(352) 728-6749
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME88925 FL Primary
Magnetic Resonance Imaging (MRI) Internal Medicine Physician 207RM1200X 88925 FL

Addresses

Primary practice location

801 E Dixie Ave
Suite 104
Leesburg, FL 34748-7601

Mailing address

734 N 3Rd St
Suite 115
Leesburg, FL 34748-5285
Phone (352) 365-2583

Other identifiers 3

IdentifierTypeStateIssuer
P00062529OtherFLRR MEDICARE LMIV
P00061039OtherFLRR MEDICARE RACF
273790600MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88925FLMDMagnetic Resonance Imaging (MRI) Internal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Central Florida L L C Diagnostic Radiology Past Accepting new patients
Tri City Radiology Group, PC Diagnostic Radiology PastSince Jun 29, 2005 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1841249869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N 3RD ST",
            "address_2": "SUITE 115",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485285",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E DIXIE AVE",
            "address_2": "SUITE 104",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487601",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "CHARLES",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME88925",
            "primary": true
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "88925",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE LMIV",
            "identifier": "P00062529",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE RACF",
            "identifier": "P00061039",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273790600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.