Charles Jeffrey Zollinger, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

M4211 Issued in ID

Practice address

393 E 2ND N
Rexburg, ID 83440-1605

Phone

(208) 356-5401

Fax

(208) 356-3111

NPI assigned

Aug 19, 2006

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

Enrolled in ID

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d61ab3e4-55bb-4859-99e6-22c413b48f2a/
• Direct secure messaging: zollincj@direct.madisonmemorial.org

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.

• Madison Co Memorial Hospital

  dba Madison Memorial Rexburg Medical Clinic

  • Family Medicine Physician
  • Rexburg, ID
  • NPI 1134592017
  Medicare reassignment NPD
• Madison Memorial Hospital

  dba Madison Clinic Physicians

  • Multi-Specialty Clinic/Center
  • Rexburg, ID
  • NPI 1346643038
  Medicare reassignment NPD
• Madison Co Memorial Hospital

  dba Rigby Medical Center

  • Family Medicine Physician
  • Rigby, ID
  • NPI 1356026280
  NPD
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  NPD
• Community Care, PLLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1003088782
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1629182282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-356-5401",
            "fax_number": "208-356-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-356-5401",
            "fax_number": "208-356-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Main St",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402048",
            "country_code": "US",
            "telephone_number": "208-356-3691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOLLINGER",
        "first_name": "CHARLES",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "M4211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004021800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rylee Yorgason, DC
• Matthew Sherman Youngberg, LMFT
• Your Supportive Services, LLC (Your Supportive Services)
• Beyron Alexis Zecher, FNP-C
• Zen Portable Massage LLC

• General Practice Physician in Rexburg, ID
• Providers in Rexburg, ID by specialty
• General Practice Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.