NPI registry status
Active
2026 NPPES data Psychiatry Physician NPI 1649236753 DO
Verify on CMS → Charles Gaines, DO
Psychiatry Physician in Johnson City, Tennessee.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 54,383 in Psychiatry Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
95
Medicare Part D claims · 44 beneficiaries · Psychiatry Physician avg: 1K
MIPS score
97.4/100
▲ 14 pts above national avg 83.5 · Exceptional
What the federal data shows
Charles Gaines, DO reported a CMS MIPS final score of 97.4/100 - above the 83.5 national average - and filed 95 Medicare Part D claims in 2024.
- 97.4/100
- MIPS score · +14 vs avg
- 95
- Part D claims, 2024
- Likely
- board-certified (heuristic)
- ≥84th
- pct among measured MIPS (lower-bound band)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Federal trust snapshot
What official records show about Charles Gaines, DO
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1649236753), first enumerated 04/26/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 95 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 97.4/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1649236753 · Psychiatry Physician
NPI-10 · ENUM-LEGACY · TAX-MEGA · MIPS-ELITE · RX-TRACE · BOOK-LIGHT · PHOTO-FINISH
- NPI-10 1649236753
- ENUM-LEGACY 2006
- TAX-MEGA 54K Psychiatry Physician
- MIPS-ELITE 97.4/100
- RX-TRACE 95
- BOOK-LIGHT 684 in Tennessee
- PHOTO-FINISH David Cook, MD · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Gaines · this pr…
Gaines · this provider
97.4 MIPS pts
- Carly Miller, M.…
Carly Miller, M.D.
97.4 MIPS pts
- David Cook, MD ·…
David Cook, MD
97.4 MIPS pts
- Syed Raza, M.D. …
Syed Raza, M.D.
97.4 MIPS pts
- Elisha Greggo, M…
Elisha Greggo, MD
97.4 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Charles Gaines, DO's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
97 ≥ 84th percentile 84% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Charles Gaines, DO sits
This provider among psychiatry physician peers
Across the 4,541 psychiatry physician providers who report both Medicare Part D prescribing and a MIPS quality score, Charles Gaines, DO writes more Part D claims than 26% of them and scores higher on MIPS quality than 84% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one psychiatry physician peer from a representative sample of 60; the gold marker is Charles Gaines, DO. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Charles Gaines, DO practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Charles Gaines, DO?
High performer (top quartile)Primary specialty
Psychiatry Physician
Medicare Part D claims
95 91% vs specialty avg
MIPS final score
97.4/100 13.9 pts vs avg
Specialty distribution in Tennessee
How Psychiatry Physician compares to other specialties among Tennessee providers
Medicare quality performance, MIPS
Charles Gaines, DO's 2023 MIPS final score plotted against the Psychiatry Physician national average
- MIPS Final Score
- 97.4/100
- vs 83.5 national avg · 2023 performance year
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Practice Address
Provider Details
| NPI | 1649236753 |
|---|---|
| Specialty | Psychiatry Physician |
| Credentials | DO |
| Gender | Male |
| NPI Issued | 04/26/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
97.4009
Final Score
Measured-score avg: 83.5
76.5564
Quality
100
Promoting Interoperability
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Charles Gaines, DO bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Appalachian Regional Healthcare Inc
Hazard, KY
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2024.
95
Total Claims
$3K
Total Drug Cost
44
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 95.1
- Total Day Supply
- 1,531
- Generic Drug Cost
- $2K
Patient Demographics
- Average Patient Age
- 53.3 years
- Avg HCC Risk Score
- 1.37
- Gender Split
- 48% female / 52% male
Psychiatry Physician Overview
How Charles Gaines, DO fits within the Psychiatry Physician landscape nationally.
54,383
Psychiatry Physician Providers in US
56
States with Psychiatry Physician
1,010
Avg Claims per Provider
Charles Gaines, DO's 95 claims are below the specialty average of 1,010.
Nationwide Psychiatry Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Gaines, both outside Tennessee so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (97.4 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Psychiatry Physician Providers in Tennessee
Other clinicians with the same primary specialty enrolled in Tennessee, drawn from the same CMS NPPES roster as Gaines.
One of 684 Psychiatry Physician providers enrolled in Tennessee, 5 are shown here.
Soureya Abbo
Clarksville, TN
Dr. Amanda Actor
MD
Nashville, TN
Dr. Lori Adelson
MD
Nashville, TN
Dr. Felix Adetunji
MD
Goodlettsville, TN
Dr. Saleh Ahmad
MD
Murfreesboro, TN
Compare Psychiatry Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Charles Gaines, DO's specialty? ▼
Charles Gaines, DO specializes in Psychiatry Physician and practices in Johnson City, Tennessee. Credentials: DO.
How much does Charles Gaines, DO prescribe under Medicare Part D? ▼
In 2024, Charles Gaines, DO wrote 95 Medicare Part D claims totaling $3K in drug costs for 44 beneficiaries.
What is Charles Gaines, DO's Medicare quality score? ▼
Charles Gaines, DO has a CMS MIPS Final Score of 97.4/100 (Quality: 76.6). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Charles Gaines, DO located? ▼
Charles Gaines, DO is located at 403 N STATE OF FRANKLIN RD, Johnson City, TN, 37604. Phone: (423) 431-7013.
What is Charles Gaines, DO's NPI number? ▼
Charles Gaines, DO's National Provider Identifier (NPI) is 1649236753, issued on 04/26/2006.
How many Psychiatry Physician providers are there in the US? ▼
There are 54,383 Psychiatry Physician providers across 56 states in the US. The average Psychiatry Physician provider writes 1,010 Medicare Part D claims per year.
Does Charles Gaines, DO accept Medicare? ▼
Charles Gaines, DO appears in CMS Medicare data with 95 Part D claims and 44 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Charles Gaines, DO's credentials? ▼
Charles Gaines, DO's NPI is 1649236753 with credentials DO. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2024). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of August 2026 (NPPES) / 2024 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.