Charles Paddack, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

46807 Issued in CO

Practice address

2848 S Lakeridge TRL
Boulder, CO 80302-9374

Phone

(720) 519-0949

Fax

(720) 519-0948

NPI assigned

Jan 22, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1205980745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 S LAKERIDGE TRL",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803029374",
            "telephone_number": "720-519-0949",
            "fax_number": "720-519-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 S LAKERIDGE TRL",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803029374",
            "telephone_number": "720-519-0949",
            "fax_number": "720-519-0948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8931 Huron St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802606806",
            "country_code": "US",
            "telephone_number": "303-853-3500",
            "fax_number": "303-853-3702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADDACK",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "46807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "788111800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Packard, L.AC
• Michele Adrienne Packard, PHD
• Mark Packer, M.D.
• David Packert, CMT
• Angela Cogburn Paddack, M.D.
• Elizabeth Starr Paddock, MA
• Armando Padua, LPN
• Cynthia Pagano, DC
• Emily Areli Paglinawan
• Pain Free Today, P.C.

• Psychiatry Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.