DR. CHARLES RAY ALDERDICE D.O. NPI 1821056649

NPI Information

  • NPI: 1821056649
  • Provider Name: DR. CHARLES RAY ALDERDICE, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1906 LANGLEY AVE
    SAINT JOSEPH, MI
    ZIP 49085
  • Phone: (269) 982-1722

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NPI Details

DR. Charles Ray Alderdice, D.O. is a family medicine in Saint Joseph, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Charles Ray Alderdice, D.O. NPI is 1821056649. 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:

1906 LANGLEY AVE
SAINT JOSEPH, MI
ZIP 49085-739
Phone: (269) 982-1722
Fax: (269) 982-1842

The NPI 1821056649 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 enumeration date for this NPI number is 5/2/2006 and was last updated on 7/1/2010.

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
1207Q00000XFamily Medicine5101008526MICHIGANYes

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
1E25585MEDICARE UPINMICHIGAN
2382531804OTHERMICHIGANTRICA
31607063MEDICAIDMICHIGAN
4134870500OTHERMICHIGANUSDEP
55110022MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICARE
6010012749OTHERMICHIGANMRRR
7015110022OTHERMICHIGANBS

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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