Active NPI
Charles Wingard Carl Jr., MD
- Psychiatry Physician
- Wayland, MA
National Provider Identifier
1891729505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 31076
- Practice address
- 16 Boston Post Rd
Ste 205
Wayland, MA 01778-2435 - Phone
- (508) 358-2050
- Fax
- (508) 358-4481
- NPI assigned
- Jul 10, 2006
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 31076 | MA | Primary |
Addresses
Primary practice location
16 Boston Post Rd
Ste 205
Wayland, MA 01778-2435
Mailing address
16 Boston Post Rd
Ste 205
Wayland, MA 01778-2435
Phone (508) 358-2050
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33616 | Other | MA | CIGNA |
| 031076 | Other | MA | TUFTS |
| 4130663 | Other | AETNA | |
| J05795 | Other | BCBS | |
| 3011739 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891729505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 BOSTON POST RD",
"address_2": "STE 205",
"city": "WAYLAND",
"state": "MA",
"postal_code": "017782435",
"telephone_number": "508-358-2050",
"fax_number": "508-358-4481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 BOSTON POST RD",
"address_2": "STE 205",
"city": "WAYLAND",
"state": "MA",
"postal_code": "017782435",
"telephone_number": "508-358-2050",
"fax_number": "508-358-4481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARL",
"first_name": "CHARLES",
"middle_name": "WINGARD",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "31076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "33616",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "031076",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4130663",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "J05795",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3011739",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayland, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.