Individual provider Active NPI

Pierre D Charles, MSN, RN, CCM

  • Case Management Registered Nurse
  • Everett, MA
National Provider Identifier
1932863784
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
RN2281239 Issued in MA
Practice address
25 Adams Ave
Everett, MA 02149-5206
Phone
(781) 539-9767
NPI assigned
Oct 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X RN2281239 MA
Continuing Education/Staff Development Registered Nurse 163WC1600X RN2281239 MA
Home Health Registered Nurse 163WH0200X RN2281239 MA
Case Management Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC0400X RN2281239 MA Primary

Addresses

Primary practice location

25 Adams Ave
Everett, MA 02149-5206

Mailing address

25 Adams Ave
Everett, MA 02149-5206
Phone (781) 539-9767

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)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2281239MAMDContinuing Education/Staff Development Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1932863784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ADAMS AVE",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495206",
            "telephone_number": "781-539-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ADAMS AVE",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495206",
            "telephone_number": "781-539-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "PIERRE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, CCM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MA",
            "license": "RN2281239",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "MA",
            "license": "RN2281239",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MA",
            "license": "RN2281239",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "MA",
            "license": "RN2281239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.