Charles D. Manter DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30988 Issued in CO

Legal business name

CHARLES D. MANTER DO PC

Doing business as

Family Medical Practice

Practice address

2918 W 10TH St
Greeley, CO 80634-5457

Phone

(970) 352-3274

Fax

(970) 352-3279

NPI assigned

Nov 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles David Manter, DO

Title

Owner

Phone

(970) 352-3274

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Medical Practice Doing business as

Locations

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1457531808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345457",
            "telephone_number": "970-352-3274",
            "fax_number": "970-352-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345457",
            "telephone_number": "970-352-3274",
            "fax_number": "970-352-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES D. MANTER DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "MANTER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-352-3274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00522830",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Greeley, CO
• Providers in Greeley, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.