Individual provider Active NPI

Kensy Jean-Charles, M.D.

  • Internal Medicine Physician
  • Gainesville, FL
National Provider Identifier
1982646493
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME83531 Issued in FL
Practice address
1601 SW Archer Rd
Ambulatory Care
Gainesville, FL 32608-1135
Phone
(352) 376-1611
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME83531 FL Primary
Emergency Medicine Physician 207P00000X ME83531 FL

Addresses

Primary practice location

1601 SW Archer Rd
Ambulatory Care
Gainesville, FL 32608-1135

Mailing address

1601 SW Archer Rd
Ambulatory Care
Gainesville, FL 32608-1135
Phone (352) 376-1611

Other identifiers 1

IdentifierTypeStateIssuer
264602100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220607001470 GA Practitioner - Emergency Medicine 1153409693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Physician Services LLCGroup PAC ID 6305100850, 33 clinicians

Practice addresses (Care Compare)

100 Frist CT
Columbus, GA 31909-3578
Phone (706) 494-2100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME83531FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Physician Services, LLC Emergency Medicine CurrentSince Apr 25, 2022 Accepting new patients
Emergency Group of Columbus, LLC Emergency Medicine CurrentSince Apr 25, 2022 Accepting new patients
K Jean-Charles MD PA Internal Medicine PastSince Jan 31, 2002 Accepting new patients

Locations

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1982646493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "address_2": "AMBULATORY CARE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "352-376-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "address_2": "AMBULATORY CARE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-CHARLES",
        "first_name": "KENSY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME83531",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME83531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264602100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.