Individual provider Active NPI

Charles E. Eberly, MD

  • Neurology Physician
  • Baton Rouge, LA
National Provider Identifier
1982693180
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
021786 Issued in LA
Practice address
10101 Park Rowe Ave
Suite 200
Baton Rouge, LA 70810-1686
Phone
(225) 769-2200
Fax
(225) 768-2185
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 021786 LA Primary

Addresses

Primary practice location

10101 Park Rowe Ave
Suite 200
Baton Rouge, LA 70810-1686

Mailing address

PO Box 98509
Baton Rouge, LA 70884-9509
Phone (225) 769-2200

Other identifiers 2

IdentifierTypeStateIssuer
1691721MedicaidLA
130023837OtherLARAILROAD MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021786LAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Neuro Medical Center Rehabilitation Hospital PastSince Nov 10, 2003 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1982693180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98509",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708849509",
            "telephone_number": "225-769-2200",
            "fax_number": "225-768-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE",
            "address_2": "SUITE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101686",
            "telephone_number": "225-769-2200",
            "fax_number": "225-768-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLY",
        "first_name": "CHARLES",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "021786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1691721",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130023837",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.