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

Dr. Jimmie R Charlie, MD

Individual provider Family Medicine Physician · NPI 1366523722

Dr. Jimmie R Charlie, MD is a Family Practice in Santo Domingo, New Mexico. Graduated from Stanford University School of Medicine in 1998, 28 years ago. Practices with Kewa Pueblo Health Corporation, a 29-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
28
Trained at
Stanford University School of Medicine
Licensed in
NM
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

85 W Highway 22
Santo Domingo, NM 87502-0340
Phone: (505) 465-3060
Fax: (505) 465-3060
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20020019 (NM)

Record details

NPI number1366523722
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 18, 2006
Last updated in NPPESSeptember 2, 2016

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduated 1998 (28 years in practice)
Group practice Kewa Pueblo Health Corporation — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount