Charles Wayne Hartzog Jr., MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

20880 Issued in AL

Practice address

4294 Lomac St
Montgomery, AL 36106-3604

Phone

(334) 274-9000

Fax

(334) 274-0857

NPI assigned

Dec 29, 2005

Last updated

Apr 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in AL

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

Sports MedicineAlso: Orthopedic Surgery

Education

University of Alabama School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hughston Clinic PCGroup PAC ID 1355254780, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Prattville, AL, CCN 017055
• Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024
• The Health Care Authority of the City of Greenville- LV Stabler Hospital Hospital, Greenville, AL, CCN 010150
• Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108
• Baptist Medical Center East Hospital, Montgomery, AL, CCN 010149

Merit-based Incentive Payment System (MIPS)

Final score

62.54 of 100Reported as individual

Quality

37.89

Promoting interoperability

89

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.hartzog.1@321.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hughston Clinic, P.C.

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1164461190

  AL

  Medicare reassignment Care Compare group NPD
• Hughston Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Newnan, GA
  • NPI 1902682347

  Orthopaedic Surgery

  NPD

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

• Centerwell Certified Healthcare Corp.

  dba Centerwell Home Health

  • Home Health Agency
  • Prattville, AL
  • NPI 1134158843
  Care Compare affiliation
• Health Care Authority for Baptist Health an Affiliate of Uabhs

  dba Baptist Medical Center East

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1104917780
  Care Compare affiliation
• Jackson Hospital & Clinic, Inc.

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1043262488
  Care Compare affiliation
• The Health Care Authority for Baptist Health an Affiliate of Uabhs

  dba Prattville Baptist Hospital

  • General Acute Care Hospital
  • Prattville, AL
  • NPI 1942391230
  Care Compare affiliation
• The Health Care Authority of the City of Greenville - LV Stabler Hospi

  dba LV Stabler Memorial Hospital

  • General Acute Care Hospital
  • Greenville, AL
  • NPI 1780655332
  Care Compare affiliation

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1952388050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4294 LOMAC ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063604",
            "telephone_number": "334-274-9000",
            "fax_number": "334-274-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZOG",
        "first_name": "CHARLES",
        "middle_name": "WAYNE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "20880",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AL",
            "license": "20880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000032697",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000032885",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200028175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC/TYNET",
            "identifier": "6455",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "940627",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0910085",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIME HEALTH",
            "identifier": "551322",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5977258",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51032697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51032885",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Harrow, PHD, MD
• Hart Chiropractic LLC (Hart Spine & Rehab)
• Jason R Hart, DC
• Denys Hartley, APRN, FNP-C
• Randi Certrina Hartsfield, LGSW
• John Gary Hartzog, CRNA
• Patricia F. Hartzog, CRNA
• Alicia Harvey
• Lakinya Harvey
• Melodye M Harvey, FNP

• Sports Medicine (Orthopaedic Surgery) Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.