Individual provider Active NPI

Charles Irving Zucker, MD

  • Family Medicine Physician
  • Greeley, CO
National Provider Identifier
1659348415
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32599 Issued in CO
Practice address
6801 W 20TH St
Suite 101
Greeley, CO 80634
Phone
(970) 378-8000
Fax
(970) 378-8088
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32599 CO Primary

Addresses

Primary practice location

6801 W 20TH St
Suite 101
Greeley, CO 80634

Mailing address

6801 W 20TH St
Suite 101,Attn:Sue
Greeley, CO 80634
Phone (970) 378-8000

Other identifiers 1

IdentifierTypeStateIssuer
01325992MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915001240 CO Practitioner - Family Practice 0143310235 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32599COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Physicians of Greeley LLP Family Medicine CurrentSince Feb 1, 1997 Accepting new patients
Family Physicians of Greeley, LLP Family Medicine CurrentSince Feb 1, 1997 Accepting new patients

Locations

2520 W 16th St
Greeley, CO 80634
Phone (970) 356-2520

6801 W 20th St
Unit 101
Greeley, CO 80634
Phone (970) 378-8000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1659348415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 W 20TH ST",
            "address_2": "SUITE 101,ATTN:SUE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-378-8000",
            "fax_number": "970-378-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 W 20TH ST",
            "address_2": "SUITE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-378-8000",
            "fax_number": "970-378-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKER",
        "first_name": "CHARLES",
        "middle_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "32599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01325992",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.