Individual provider Active NPI

Charles Franklin McDonell Jr., MD

  • Gynecology Physician
  • Hickory, NC
National Provider Identifier
1891754727
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
19178 Issued in NC
Practice address
210 13TH Avenue PL NW
Hickory, NC 28601-2532
Phone
(828) 322-3017
Fax
(828) 322-1087
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 19178 NC Primary

Addresses

Primary practice location

210 13TH Avenue PL NW
Hickory, NC 28601-2532

Mailing address

210 13TH Avenue PL NW
Hickory, NC 28601-2532
Phone (828) 322-3017

Other identifiers 1

IdentifierTypeStateIssuer
8956265MedicaidNC

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

State licenses

LicenseStateTypeSpecialty
19178NCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1891754727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 13TH AVENUE PL NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012532",
            "telephone_number": "828-322-3017",
            "fax_number": "828-322-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 13TH AVENUE PL NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012532",
            "telephone_number": "828-322-3017",
            "fax_number": "828-322-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONELL",
        "first_name": "CHARLES",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "19178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8956265",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.