Charles McKinley Zollicoffer, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME 97653 Issued in FL

Practice address

1871 SE Tiffany Ave
Suite 200
Port St Lucie, FL 34952-7585

Phone

(772) 337-4000

Fax

(772) 335-4054

NPI assigned

Sep 14, 2006

Last updated

Mar 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Obstetrics/Gynecology

Education

Boston University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Community Health Centers IncGroup PAC ID 9931017126, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.zollicoffer.1@14865.direct.athenahealth.com

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.

• Florida Community Health Centers Inc

  • Family Medicine Physician
  • Pahokee, FL
  • NPI 1851518211
  Medicare reassignment Care Compare group NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Boca Raton, FL
  • NPI 1710647334
  Medicare reassignment NPD
• Florida Community Health Centers Inc

  • Family Medicine Physician
  • Clewiston, FL
  • NPI 1124078571
  NPD
• Florida Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Moore Haven, FL
  • NPI 1194071944
  NPD
• Florida Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Port St Lucie, FL
  • NPI 1215986872

  Obstetrics & Gynecology

  NPD
• Florida Community Health Centers Inc

  • Family Medicine Physician
  • Okeechobee, FL
  • NPI 1952351306

  Obstetrics & Gynecology

  NPD
• Florida Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Pierce, FL
  • NPI 1104875095

  Obstetrics & Gynecology

  NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1457011751
  NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Winter Haven, FL
  • NPI 1851282016
  NPD
• Florida Community Health Centers, Inc.

  dba Grace Women's Health Center

  • Federally Qualified Health Center (FQHC)
  • Fort Pierce, FL
  • NPI 1104250786

  Obstetrics & Gynecology

  NPD (past)
• Florida Community Health Centers, Inc.

  dba Florida Community Health Centers, Inc.- Corporate

  • Federally Qualified Health Center (FQHC)
  • West Palm Beach, FL
  • NPI 1144288432

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1750486460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443",
            "fax_number": "561-472-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 SE TIFFANY AVE",
            "address_2": "SUITE 200",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527585",
            "telephone_number": "772-337-4000",
            "fax_number": "772-335-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLICOFFER",
        "first_name": "CHARLES",
        "middle_name": "MCKINLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "231571",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME 97653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME97653",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278332100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Zanto, DO
• Peter S Zeblisky, D.O.
• Gobnait Zick
• Kenneth John Zielinski, RPH
• Paige H Ziemba, LMT
• Ashkahn Zomorrodi, DO
• Betty Zondag, O.D.

• Obstetrics & Gynecology Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.