Active NPI
Charles W Maile, MD
- Diagnostic Radiology Physician
- Sandpoint, ID
National Provider Identifier
1841291861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- M9573
- Practice address
- 520 North Third
Sandpoint, ID 83864-1507 - Phone
- (208) 263-1441
- Fax
- (208) 265-1278
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Ultrasound Physician | 2085U0001X | 25618 | MN | |
| Body Imaging Physician | 2085B0100X | 25618 | MN | |
| Diagnostic Radiology Physician | 2085R0202X | 25618 | MN | |
| Diagnostic Radiology Physician | 2085R0202X | M9573 | ID | Primary |
Addresses
Primary practice location
520 North Third
Sandpoint, ID 83864-1507
Mailing address
PO Box 1448
Sandpoint, ID 83864-0877
Phone (208) 263-1441
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807532600 | Medicaid | ID | |
| 787573800 | Medicaid | MN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25618 | MN | MD | Psychiatry Physician |
| M9573 | ID | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265328000000",
"number": "1841291861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1448",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838640877",
"telephone_number": "208-263-1441",
"fax_number": "208-265-1278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 NORTH THIRD",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838641507",
"telephone_number": "208-263-1441",
"fax_number": "208-265-1278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILE",
"first_name": "CHARLES",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2010-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "MN",
"license": "25618",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "MN",
"license": "25618",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "25618",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ID",
"license": "M9573",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807532600",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "787573800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.