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Charles Anthony Ancrum , RN

Registered Nurse β€’ Covington, GA

Active NPI 1306078357 Individual Practitioner Male Practitioner
Practice location in NPPES

20 Riverstone Dr
Covington, GA 300145027

Call 4045105027 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

20 Riverstone Dr

Covington, GA 300145027

Telephone 4045105027

NPI first issued

2009

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Covington and Georgia

28 active clinicians are listed under Registered Nurse with a practice address in Covington, GA (3,289 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Covington

0% of these 28 clinicians have the CMS telehealth indicator.

0% of these 28 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-06
Registered Nurse Primary Specialty

NUCC Taxonomy Code: 163W00000X

License # reported to NPPES NY 622351

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Registered Nurse - Continuing Education/Staff Development

NUCC Taxonomy Code: 163WC1600X

License # reported to NPPES GA 622351-01
Registered Nurse - Critical Care Medicine

NUCC Taxonomy Code: 163WC0200X

License # reported to NPPES GA 622351-01
Registered Nurse - Wound Care

NUCC Taxonomy Code: 163WW0000X

License # reported to NPPES GA 622351-01
Registered Nurse - Administrator

NUCC Taxonomy Code: 163WA2000X

License # reported to NPPES GA 622351-01
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location September 06, 2025

Registered at 20 RIVERSTONE DR, COVINGTON, GA 300145027 (Tel: 4045105027)

πŸ“
Updated Business Mailing Address September 06, 2025

Registered at 20 RIVERSTONE DR, COVINGTON, GA 300145027 (Tel: 4045105027)

βœ…
NPI Profile Active April 06, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 06, 2010

Registered at 596 EDGECOMBE AVE, # 5F, NEW YORK, NY 100324333 (Tel: 9174727444)

πŸ“
Business Mailing Address (Initial Record) April 06, 2010

Registered at 596 EDGECOMBE AVE, # 5F, NEW YORK, NY 100324333 (Tel: 9174727444)

πŸ‘€
Provider Name / Credentials (Initial Record) April 06, 2010

Recorded as CHARLES ANCRUM, RN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2010

Registered Nurse (license number reported to NPPES: NY 622351)

🟒
Initial NPI Registration & Enumeration August 10, 2009

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1306078357
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 10, 2009
Last Update: September 06, 2025
Sole Proprietor: No

Mailing Address

20 Riverstone Dr

Covington, GA 300145027

Phone: 4045105027

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.