Individual provider Active NPI

C David Neece, D.O.

  • General Practice Physician
  • Walsenburg, CO
National Provider Identifier
1255364485
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
27053 Issued in CO
Practice address
100 W 4TH St
Walsenburg, CO 81089-1910
Phone
(719) 738-1164
Fax
(719) 738-3399
NPI assigned
Jul 9, 2006
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 27053 CO Primary

Addresses

Primary practice location

100 W 4TH St
Walsenburg, CO 81089-1910

Mailing address

100 W 4TH St
Walsenburg, CO 81089-1910
Phone (719) 738-1164

Other identifiers 1

IdentifierTypeStateIssuer
01270537MedicaidCO

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
I20110322000130 CO Practitioner - General PracticePractitioner - Family Practice 4082645403 Receives reassigned benefits from 1 practitioner
Practice locations: Walsenburg, CO

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27053COMDGeneral Practice Physician

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1255364485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891910",
            "telephone_number": "719-738-1164",
            "fax_number": "719-738-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891910",
            "telephone_number": "719-738-1164",
            "fax_number": "719-738-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEECE",
        "first_name": "C DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "27053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01270537",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walsenburg, CO

Sources for this page

Verify at the official NPI Registry.