Charles E Myers, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01025417 Issued in IN

Practice address

303 S Main St
Suite 108
Mishawaka, IN 46544-2159

Phone

(574) 255-3108

Fax

(574) 255-3100

NPI assigned

Sep 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  NPD (past)
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1124079330
  NPD (past)
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • La Porte, IN
  • NPI 1639129117
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1891781852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S MAIN ST",
            "address_2": "SUITE 108",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442159",
            "telephone_number": "574-255-3108",
            "fax_number": "574-255-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S MAIN ST",
            "address_2": "SUITE 108",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442159",
            "telephone_number": "574-255-3108",
            "fax_number": "574-255-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01025417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100222130",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Musheer Enterprises LLC
• Anne Lise Sullivan Musselman, CNM
• Lilian Kagendo Mwangi, FNP-C
• Sete Mwanza
• Adina Myers
• Krista Myers
• Michael Myers
• Myeyedr Optometry of Indiana, LLC
• Harsha Santheshivara Nagarajarao, M.D.
• Sushruta Shantanu Nagarkatti, M.B.B.S.

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.