Individual provider Active NPI

Gregory H Colbert, DPM

  • Podiatrist
  • Charlotte, MI
National Provider Identifier
1558332015
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
GC001416 Issued in MI
Practice address
436 W Lawrence Ave
Charlotte, MI 48813-1442
Phone
(517) 543-0505
NPI assigned
Jan 31, 2006
Last updated
Dec 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X GC001416 MI Primary

Addresses

Primary practice location

436 W Lawrence Ave
Charlotte, MI 48813-1442

Mailing address

436 W Lawrence Ave
PO Box 735
Charlotte, MI 48813-1442
Phone (517) 543-0505

Other identifiers 1

IdentifierTypeStateIssuer
4706341MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071119000435 MI Practitioner - Podiatry 9638267024 Practice locations: Cadillac, MI; Mount Pleasant, MI; Mason, MI; Charlotte, MI; Brighton, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
GC001416MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
John Street Clinic PC Past Accepting new patients
Sweetwater Medical Center Past Accepting new patients
Retirement Living Management of Mt. Pleasant Past Accepting new patients
Devonshire Manor Inc. Past Accepting new patients
Isidore Steiner DPM PC Podiatrist Past Accepting new patients
Retirement Living Management of Cadillac, L.L.C Past Accepting new patients

Organizations & group practices 7

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1558332015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 W LAWRENCE AVE",
            "address_2": "PO BOX 735",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131442",
            "telephone_number": "517-543-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 W LAWRENCE AVE",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131442",
            "telephone_number": "517-543-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "GREGORY",
        "middle_name": "H",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "GC001416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4706341",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, MI

Sources for this page

Verify at the official NPI Registry.