NPIMap

Individual provider Active NPI

Charles David Manter, DO

  • Family Medicine Physician
  • Greeley, CO
National Provider Identifier
1770670424
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30988 Issued in CO
Practice address
2918 W 10TH St
Greeley, CO 80634-5472
Phone
(970) 352-3274
Fax
(970) 352-3279
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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 30988 CO Primary

Addresses

Primary practice location

2918 W 10TH St
Greeley, CO 80634-5472

Mailing address

2918 W 10TH St
Greeley, CO 80634-5457
Phone (970) 352-3274

Other identifiers 1

IdentifierTypeStateIssuer
01309889MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmanter@YDHC.cerner.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000692 CO Practitioner - Family PracticePractitioner - General PracticePractitioner - Osteopathic Manipulative Medicine 5395642367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

1000 W S Boulder Rd
Suite 110
Lafayette, CO 80026-2753
Phone (303) 415-4355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30988COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Northern Colorado CurrentSince Aug 1, 2023 Accepting new patients
Boulder Community Health CurrentSince May 1, 2024 Accepting new patients
Boulder Community Health CurrentSince May 1, 2024 Accepting new patients
Boulder Community Health Current Accepting new patients
Greeley Internal Medicine & Nephrology Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

2804 S Timberline Rd
Fort Collins, CO 80525
Phone (970) 672-4026

1000 W South Boulder Rd
Ste 110
Lafayette, CO 80026
Phone (303) 415-4355

Interoperability endpoints

  • Direct secure messaging: cmanter@ydhc.cerner.com

Organizations & group practices 6

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.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1770670424",
    "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": "806345472",
            "telephone_number": "970-352-3274",
            "fax_number": "970-352-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTER",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01309889",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmanter@YDHC.cerner.com",
            "affiliation": "N",
            "endpointDescription": "Charles Manter Yuma District Hospital Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "82 Main Ave",
            "city": "Akron",
            "state": "CO",
            "country_code": "US",
            "postal_code": "807201440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.