Individual provider Active NPI

Charles Lee Liggett Jr., M.D.

  • Family Medicine Physician
  • Hampton, AR
National Provider Identifier
1972517027
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0197 Issued in AR
Practice address
402 South Lee Street
Hampton, AR 71744-1196
Phone
(870) 798-4299
Fax
(870) 798-2425
NPI assigned
Jul 27, 2006
Last updated
Aug 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X FLME0026189 FL
Family Medicine Physician 207Q00000X E0197 AR Primary

Addresses

Primary practice location

402 South Lee Street
Hampton, AR 71744-1196

Mailing address

402 South Lee Street
Hampton, AR 71744-1196
Phone (870) 798-4299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20050909000301 TX Practitioner - Family PracticePractitioner - General SurgeryPractitioner - Emergency Medicine 0345141164 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
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

LicenseStateTypeSpecialty
FLME0026189FLMDSpecialist
E0197ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Jul 1, 2014 Accepting new patients
Victoria Emergency Partners LLC CurrentSince Apr 20, 2015 Accepting new patients
Sterling Initiatives CurrentSince Nov 15, 2024 Accepting new patients
Sterling Initiatives CurrentSince Nov 15, 2024 Accepting new patients
Victoria Emergency Associates LLC CurrentSince May 1, 2015 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jul 1, 2014 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

101 Avenue J
Anson, TX 79501
Phone (325) 823-3231

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1972517027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 SOUTH LEE STREET",
            "city": "HAMPTON",
            "state": "AR",
            "postal_code": "717441196",
            "telephone_number": "870-798-4299",
            "fax_number": "870-798-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SOUTH LEE STREET",
            "city": "HAMPTON",
            "state": "AR",
            "postal_code": "717441196",
            "telephone_number": "870-798-4299",
            "fax_number": "870-798-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGGETT",
        "first_name": "CHARLES",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "FLME0026189",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, AR

Sources for this page

Verify at the official NPI Registry.