Individual provider Active NPI

Charles Graham Jones, MD

  • Surgery Physician
  • Boulder, CO
National Provider Identifier
1104909381
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR.0019845 Issued in CO
Practice address
4743 Arapahoe Ave
Suite 100
Boulder, CO 80303-1113
Phone
(303) 443-2123
Fax
(303) 443-9497
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X DR.0019845 CO Primary

Addresses

Primary practice location

4743 Arapahoe Ave
Suite 100
Boulder, CO 80303-1113

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 443-2123

Other identifiers 1

IdentifierTypeStateIssuer
01198456MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101211000067 CO Practitioner - General SurgeryPractitioner - Vascular Surgery 8325116361 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Apr 1, 2016 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Apr 1, 2016 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

4743 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-4599

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

1155 Alpine Ave
Ste 150
Boulder, CO 80304
Phone (303) 245-7056

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1104909381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-443-2123",
            "fax_number": "303-443-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 ARAPAHOE AVE",
            "address_2": "SUITE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031113",
            "telephone_number": "303-443-2123",
            "fax_number": "303-443-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CHARLES",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0019845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01198456",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.