DR. CHARLES DAVID ETTELSON M.D.
NPI 1255332904
Surgery - Plastic and Reconstructive Surgery in Saint Louis, MO
NPI Status: Active since August 03, 2005
Contact Information
730 AUDUBON DR
SAINT LOUIS, MO
ZIP 63105
Phone: (314) 324-7605
- Individual
- Male
- Surgery
- Plastic and Reconstructive Surgery
About CHARLES ETTELSON
This page provides the complete NPI Profile along with additional information for Charles Ettelson, a provider established in Saint Louis, Missouri with a medical specialization in Surgery, focusing in plastic and reconstructive surgery . The healthcare provider is registered in the NPI registry with number 1255332904 assigned on August 2005. The practitioner's primary taxonomy code is 2086S0122X with license number R9446 (MO). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1255332904
- Provider Name
- DR. CHARLES DAVID ETTELSON M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 730 AUDUBON DR SAINT LOUIS, MO 63105
- Location Phone
- (314) 324-7605
- Mailing Address
- 730 AUDUBON DR SAINT LOUIS, MO 63105
- Mailing Phone
- (314) 324-7605
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-03-2005
- Last Update Date
- 07-02-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery Plastic and Reconstructive Surgery
- Taxonomy Code
- 2086S0122X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R9446
- License State
- MO
- Taxonomy Description
- A surgeon who specializes in plastic and reconstructive surgery.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000000033 | MEDICARE ID-TYPE UNSPECIFIED (04) | MO | |
| AEO957 | MEDICARE UPIN (02) | MO |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 5 | 5 | 3 | 3 | 2 | 9 | 0 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 10 | 5 | 6 | 3 | 4 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 0 + 5 + 6 + 3 + 4 + 9 + 0 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1255332904 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255332904, enumerated as an "individual" on August 03, 2005.
The provider is located at 730 AUDUBON DR SAINT LOUIS, MO 63105 and the phone number is (314) 324-7605.
Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
