Active NPI
Charlene Deanne Guggenheim, MD
- Pediatric Adolescent Medicine Physician
- Aspen, CO
National Provider Identifier
1831198753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 34356
- Practice address
- 101 Founders PL
Suite 109
Aspen, CO 81611-1476 - Phone
- (970) 920-0104
- Fax
- (970) 920-0124
- NPI assigned
- Jul 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 34356 | CO | Primary |
Addresses
Primary practice location
101 Founders PL
Suite 109
Aspen, CO 81611-1476
Mailing address
101 Founders PL
Suite 109
Aspen, CO 81611-1476
Phone (970) 920-0104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01343565 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34356 | CO | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspen Medical Care, PC | Adolescent Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243555200000",
"number": "1831198753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 FOUNDERS PL",
"address_2": "SUITE 109",
"city": "ASPEN",
"state": "CO",
"postal_code": "816111476",
"telephone_number": "970-920-0104",
"fax_number": "970-920-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 FOUNDERS PL",
"address_2": "SUITE 109",
"city": "ASPEN",
"state": "CO",
"postal_code": "816111476",
"telephone_number": "970-920-0104",
"fax_number": "970-920-0124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUGGENHEIM",
"first_name": "CHARLENE",
"middle_name": "DEANNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-21",
"last_updated": "2009-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "CO",
"license": "34356",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01343565",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aspen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.