Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Charles Shane Medlock, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1619125671

Charles Shane Medlock, MD is an Obstetrics/Gynecology in Pensacola, Florida. Qualified in 2005, 21 years ago. Practices with Sacred Heart Health System Inc, a 373-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
21
Licensed in
FL
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5153 N 9th Ave Ste 207
Pensacola, FL 32504-5705
Phone: (850) 416-5050
Fax: (850) 416-5022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence ME8722 (FL)

Record details

NPI number1619125671
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 3, 2008
Last updated in NPPESDecember 6, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Sacred Heart Health System Inc — 373 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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