CHARLES RIDGEWAY PAYNE – Nurse Practitioner, NPI 1164128062

CHARLES RIDGEWAY PAYNE is a healthcare provider. based in Fultondale, Alabama. specializing in NURSE PRACTITIONER. They hold a License No. 1-171896 (AL). The NPI Number for CHARLES RIDGEWAY PAYNE is 1164128062

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES RIDGEWAY PAYNE
NPI
1164128062
Phone
(205) 535-6011
Address
3631 GRAND CENTRAL AVE
Enumeration Date
1 February 2023
Last Update Date
13 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
2058383450
Graduation Year
2024 (2 years ago)
PAC ID
5092240044
Group Practice PAC ID
3971417825
Professional Enrollment ID
I20241127001450
Address ID
AL352353401BI50XXXEXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for CHARLES RIDGEWAY PAYNE

  • 3631 GRAND CENTRAL AVE

    FULTONDALE, AL 350681997

    Phone: (205) 535-6011

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241127001450INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35068)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971417825View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to CHARLES RIDGEWAY PAYNE?
NPI 1164128062 is assigned to CHARLES RIDGEWAY PAYNE under the national enumeration system.
Is CHARLES RIDGEWAY PAYNE's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize CHARLES RIDGEWAY PAYNE's specialty in plain language?
Clinically, the directory lists CHARLES RIDGEWAY PAYNE with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place CHARLES RIDGEWAY PAYNE?
The snapshot lists Fultondale, Alabama for CHARLES RIDGEWAY PAYNE; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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