Charles Iverson Hooper, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5310 Issued in CA

Practice address

6339 Mack Rd
Sacramento, CA 95823-4655

Phone

(916) 454-2345

Fax

(916) 457-2667

NPI assigned

Aug 20, 2006

Last updated

Mar 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853
  Medicare reassignment NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1154947711
  NPD
• Medical Marts LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
  • NPI 1053322834
  NPD (past)
• St. Mark's South Jordan Family Practice LLC

  dba South Jordan Family Medicine

  • Family Medicine Physician
  • South Jordan, UT
  • NPI 1982871828
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1174638068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484",
            "fax_number": "916-256-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6339 MACK RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234655",
            "telephone_number": "916-454-2345",
            "fax_number": "916-457-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "CHARLES",
        "middle_name": "IVERSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Brittany Hook Dye, MSW
• Ryan Stewart Hook
• Thomas Eugene Hookano, JD
• Jacqueline Ashlee Hooks
• Leesa Hooks
• Hosson David Hooper, MS
• Nicole Aleece Hoopes
• Hooria Health and Maternal Support LLC
• Holly Marie Hooton, LMFT
• Joshua Hoover, LCSW

• Family Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.