Mary Wampler Charles, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9107425 Issued in FL

Practice address

1315 S Howard Ave
Suite 102
Tampa, FL 33606-3193

Phone

(813) 350-9090

Fax

(813) 443-5783

NPI assigned

Sep 5, 2013

Last updated

Mar 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Radley L Griffin MD PL

  • Specialist
  • Tampa, FL
  • NPI 1194908517
  NPD (past)

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1871928127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 S HOWARD AVE",
            "address_2": "SUITE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063193",
            "telephone_number": "813-350-9090",
            "fax_number": "813-443-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S HOWARD AVE",
            "address_2": "SUITE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063193",
            "telephone_number": "813-350-9090",
            "fax_number": "813-443-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MARY",
        "middle_name": "WAMPLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Metellus Charles, LCSW
• Dillion Kyle Charles
• Jennifer Charles, RBT
• Jodea A Charles, PA-C
• Kimberley B. Charles, LCSW
• Medelina Charles
• Nancy Madell Charles, MS CCCSLP
• Sharon Charles, APRN
• Stanley Charles
• Valenca Charles

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.