DR. CHARLES C BOACKLE (NPI# 1104935287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104935287 |
| Entity Type | Individual |
| Full Name | DR. CHARLES C BOACKLE |
| Credential | MD |
| Practice Address |
513 Brookwood Blvd Suite 50 Birmingham AL 35209-6862 |
| Practice Telephone | 2058772761 |
| Practice Fax Number | 2058772399 |
| Mailing Telephone | 2058772761 |
| Mailing Fax Number | 2058772399 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 10381 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VIVA | C73058 | 01 | |
| CIGNA | 631266801 0054 | 01 |
| Street Address |
513 BROOKWOOD BLVD SUITE 50 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209-6862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073599023 | Unal Tutak | Anesthesiology | 513 Brookwood Blvd, Suite 101, Birmingham, AL 35209-6862 | 2005-12-21 |
| 1932608361 | Anesthesiology Services | Anesthesiology | 513 Brookwood Blvd, Suite 101, Birmingham, AL 35209 | 2018-02-12 |
| 1013458694 | Danielle Blackard | Nurse Practitioner | 513 Brookwood Blvd, Suite 401, Birmingham, AL 35209-6862 | 2017-03-15 |
| 1861848889 | Ashley Files | Nurse Practitioner | 513 Brookwood Blvd, Suite 401, Birmingham, AL 35209-6862 | 2016-05-09 |
| 1538520721 | Brookwood Diagnostic Imaging Center, LLC | Clinic/Center | 513 Brookwood Blvd, Suite 100, Birmingham, AL 35209-6878 | 2016-03-15 |
| 1790163053 | Erin Ann Esskuchen | Nurse Practitioner | 513 Brookwood Blvd, Suite 401, Birmingham, AL 35209-6862 | 2015-05-07 |
| 1447640628 | Rachel Messer | Nurse Practitioner | 513 Brookwood Blvd, Suite 275, Birmingham, AL 35209-6862 | 2015-01-27 |
| 1104258532 | Coretta H. Collins | Nurse Practitioner | 513 Brookwood Blvd, Suite 275, Birmingham, AL 35209-6862 | 2013-08-08 |
| 1154761310 | Brookwood Specialty Care Endocrinology, LLC | Internal Medicine | 513 Brookwood Blvd, Ste 400, Birmingham, AL 35209-6862 | 2013-07-02 |
| 1699017293 | Lauren Martin Gibson | Orthopaedic Surgery | 513 Brookwood Blvd, Suite 400, Birmingham, AL 35209-6862 | 2013-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872999 | Robert C. Cain, M.d., LLC | Internal Medicine | 5381 1st Ave N, Birmingham, AL 35212-2401 | 2020-05-07 |
| 1710432083 | Daniela Urina Jassir | Internal Medicine | 1720 2nd Ave S # Tht321, Birmingham, AL 35294-0004 | 2016-08-16 |
| 1942650023 | Swaroop Vitta | Internal Medicine | 1720 2nd Ave S # Bdb355, Birmingham, AL 35294-0012 | 2016-06-20 |
| 1477900736 | Nathan Terry Douthit | Internal Medicine | 801 Princeton Ave Sw Ste 228, Birmingham, AL 35211-1310 | 2016-05-17 |
| 1104289735 | Joe W. Chiles IIi | Internal Medicine | 1720 2nd Ave S # Tht422, Birmingham, AL 35294-0004 | 2016-03-31 |
| 1346602752 | Joshua Thomas Gautney | Internal Medicine | 1900 University Blvd Tinsley Harrison Tower Tht422, Birmingham, AL 35294-7201 | 2016-03-24 |
| 1366817199 | Stv Cardiology Clinic LLC | Internal Medicine | 46 Medical Park East Drive, Building 46, Suite 460, Birmingham, AL 35235-3401 | 2015-12-04 |
| 1891160875 | Thomas Lee Baumann | Internal Medicine | 3805 Kinross Dr, Birmingham, AL 35242-5803 | 2015-12-02 |
| 1295122281 | Audrey Rebecca Lloyd | Internal Medicine | Tht 229 1720 2nd Ave South, Birmingham, AL 35294-0001 | 2015-04-17 |
| 1154715365 | Danielle Demontigny Avila | Internal Medicine | 625 19th St. South, Birmingham, AL 35249 | 2015-03-25 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35209 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.