Active NPI
Charles Kent Powers III, M.D.
- Pediatrics Physician
- Gainesville, FL
National Provider Identifier
1861803264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME132034
- Practice address
- 5612 NW 43Rd St
Gainesville, FL 32653-3332 - Phone
- (352) 376-4542
- Fax
- (352) 376-4959
- NPI assigned
- May 19, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME132034 | FL | Primary |
Addresses
Primary practice location
5612 NW 43Rd St
Gainesville, FL 32653-3332
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (352) 376-4542
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021744500 | Medicaid | FL | |
| OB926 | Other | FL | FL MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME132034 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Privia Medical Group Florida, LLC | Past | Accepting new patients |
Locations
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
Interoperability endpoints
- charles.powers.1@8042.direct.athenahealth.com
- cpowers71627@direct.shands.ufl.edu
Organizations & group practices 3
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.
-
- Surgery Physician
- Gainesville, FL
- NPI 1063463768
-
- Durable Medical Equipment & Medical Supplies
- Ocala, FL
- NPI 1609529478
-
- General Practice Physician
- Indialantic, FL
- NPI 1700649043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1861803264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "352-376-4542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5612 NW 43RD ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326533332",
"telephone_number": "352-376-4542",
"fax_number": "352-376-4959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWERS",
"first_name": "CHARLES",
"middle_name": "KENT",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME132034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "021744500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL MEDICARE",
"identifier": "OB926",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.