Charles Langdon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301041022 Issued in MI

Practice address

2332 Alpine Ave NW
Grand Rapids, MI 49544-1955

Phone

(616) 391-2503

Fax

(616) 391-6219

NPI assigned

May 5, 2006

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 7

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Spectrum Health Primary Care Partners

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1821422007
  NPD
• Spectrum Health Hospitals

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1598712390
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1871541300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-2503",
            "fax_number": "616-391-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 ALPINE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441955",
            "telephone_number": "616-391-2503",
            "fax_number": "616-391-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGDON",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1104128161",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4773765",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1598712390",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4770914",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4770960",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4774010",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4771125",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Robert Lang, OTR/L
• Kurt Lang, DC
• Rachael Lang
• Robert D. Lang, MD
• Alissa Langan
• Nicholas Mark Lange, LPC/LMFT
• Rebecca Lange
• Dawn Langejans
• Carol A. Langeland, OTRL
• Robert Francis Langen, MD

• Internal Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.

Verify at the official NPI Registry.