Carrie Charlton, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A119995 Issued in CA

Practice address

11234 Anderson St
Gme Office CP 21005
Loma Linda, CA 92354-2804

Phone

(909) 558-4000

NPI assigned

Apr 15, 2010

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Emergency Medicine

Education

Boston University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccharlton1657560@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Centinela Freeman Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1528333101
  Medicare reassignment NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1891011847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "CARRIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A119995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccharlton1657560@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1165 Montgomery Dr",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Chao
• Daniel Chao, M.D.
• Martha Chao, CRNA
• Janessa Ann Charles-Marcel, MD
• Melissa S Charles, MD, PHD
• Alissa Charvonia
• Resa Louise Chase, M.D.
• Payush Chatta
• Brian Chau, MD
• Minh-Hang Chau, M.D.

• Emergency Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.