Individual provider Active NPI

Charles M. Iker, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1790744787
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R035927 Issued in NY
Practice address
160 Allens Creek Rd
Rochester, NY 14618-3309
Phone
(585) 461-4810
Fax
(585) 271-8916
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R035927 NY Primary

Addresses

Primary practice location

160 Allens Creek Rd
Rochester, NY 14618-3309

Mailing address

160 Allens Creek Rd
Rochester, NY 14618-3309
Phone (585) 461-4810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000683 NY Practitioner - Clinical Social Worker 7416840145 Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R035927NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790744787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ALLENS CREEK RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183309",
            "telephone_number": "585-461-4810",
            "fax_number": "585-271-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALLENS CREEK RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183309",
            "telephone_number": "585-461-4810",
            "fax_number": "585-271-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKER",
        "first_name": "CHARLES",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R035927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.