Charles Russell Pollard, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

CP038083 Issued in MI

Practice address

300 S Rath Ave
Suite 102
Ludington, MI 49431-3003

Phone

(231) 843-2543

NPI assigned

Feb 18, 2007

Last updated

Apr 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Health Partners

  dba Trinity Health Medical Group

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  NPD
• Mercy Health Partners

  dba Trinity Health Medical Group

  • Rural Health Clinic/Center
  • Shelby, MI
  • NPI 1700201712

  Family Medicine

  NPD
• Oakview Medical Care Facility

  • Skilled Nursing Facility
  • Ludington, MI
  • NPI 1427051473
  NPD (past)

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1851435283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S RATH AVE",
            "address_2": "SUITE 102",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494313003",
            "telephone_number": "231-843-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S RATH AVE",
            "address_2": "SUITE 102",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494313003",
            "telephone_number": "231-843-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "CHARLES",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-18",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "CP038083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0805336581",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100810",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylin Petzak, PHARM.D.
• Kylie Petzak, RN
• Michelle Piwowarski, PT, DPT
• Vicki Platt
• Ellen Plummer, LMSW
• Debra Pomorski, RN
• Danielle Popovits, MSW, LLMSW
• Positive Life, L.L.C.
• Patrick Edward Powers, RPH
• Sherri Pretty

• Family Medicine Physician in Ludington, MI
• Providers in Ludington, 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 Apr 22, 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.