Charles Calvin Henson, DO
Individual provider Active NPI Emergency Medicine Physician · Seminole, OK
NPI 1962590968 · NPPES record last updated Jul 30, 2015
Key facts
- NPI
- 1962590968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 20090014870 (MO)
- Practice address
- 2401 W Wrangler Blvd
Seminole, OK 74868-1917 - Phone
- (405) 303-4000
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Kansas City University of Physicians and Surgeons, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Midwest Emergency Medical Services PC
Practice addresses (Care Compare)
2800 Clay Edwards Dr
N Kansas City, MO 64116-3220
Phone (816) 346-7220
Hospital & facility affiliations
- NKC Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090818000574 | MO | Practitioner - Emergency Medicine | 5496752461 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20090014870 | MO | MD | Emergency Medicine Physician |
| 4415 | OK | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Emergency Medical Services PC | Emergency Medicine | Current |
Accepting new patients |
| Norstar Emergency Physicians | Past | Accepting new patients | |
| Seminole Health Center LLC | Past | Accepting new patients | |
| Lightstar Emergency Physicians, PLLC | Emergency Medicine | Past | Accepting new patients |
Locations
2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4415 | OK | |
| Emergency Medicine Physician | 207P00000X | 20090014870 | MO | Yes |
Addresses
Primary practice location
2401 W Wrangler Blvd
Seminole, OK 74868-1917
Mailing address
3555 NW 58TH St
Suite 900
Oklahoma City, OK 73112-4707
Other providers in Seminole, OK
- Melissa Ann Harris
- Harry C Fisher D O P C
- Lisa Dawn Harvey
- Staci Hayes
- Alyson Heath
- Cleta Ann Hilburn
- June Marie Hill
- Dana Marie Hobbs
- Brooke Nicole Houck
- Lawrence Pettway Howzw III
All providers in Seminole, OK · Emergency Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.