DR. CHARLES BEVERLY LYTLE GERVAIS M.D.
NPI 1235508904
Student in an Organized Health Care Education/Training Program in Scottsdale, AZ

Q: What is Charles Gervais's NPI number?

The NPI number for Charles Gervais is 1235508904. It was assigned to this individual provider in the NPPES registry on September 23, 2015.

Q: What is Charles Gervais's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Gervais was last updated on September 23, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 23, 2015PECOS Enrolled

13400 E SHEA BLVD, SCOTTSDALE, AZ 85259(480) 301-8000 Get Directions Write a Review

NPPES record last updated: September 23, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Dr. Charles Beverly Lytle Gervais M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES BEVERLY LYTLE GERVAIS M.D. (NPI 1235508904) is an individual student in an organized health care education/training program in Scottsdale, Arizona and active in the NPI registry since September 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235508904

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. CHARLES BEVERLY LYTLE GERVAISCredential: M.D.

Location Address13400 E SHEA BLVDScottsdale, AZ 85259-5452

Mailing Address13400 E Shea BlvdScottsdale, AZ 85259-5452 · (480) 301-8000

Phone(480) 301-8000

Sole ProprietorNo

Enumeration DateSeptember 23, 2015

✔ NPI 1235508904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

13400 E SHEA BLVD, Scottsdale, AZ 85259

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charles Beverly Lytle Gervais M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Leave this field empty

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMITKUMAR MEHTA MD

Internal Medicine (Hematology & Oncology)