MATTHEW CHARLES NPI 1770913089

NPI Information

  • NPI: 1770913089
  • Provider Name: MATTHEW CHARLES
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10004 KENNERLY RD
    STE 364B
    SAINT LOUIS, MO
    ZIP 63128
  • Phone: (314) 525-4429

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NPI Details

Matthew Charles is a psychiatric/mental health nurse practitioner in Saint Louis, MO with 13 years of experience. Matthew Charles NPI is 1770913089. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10004 KENNERLY RD
STE 364B
SAINT LOUIS, MO
ZIP 63128-141
Phone: (314) 525-4429
Fax: (314) 525-7260

The NPI 1770913089 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or (HCPCS:G2212)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)

The enumeration date for this NPI number is 11/22/2013 and was last updated on 3/14/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WP0809XRegistered NursePsychiatric/Mental Health, Adult2013037719MISSOURINo
2363LP0808XNurse PractitionerPsychiatric/Mental Health2013037719MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11770913089MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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