NPIMap

Individual provider Active NPI

Charles Zachary Marriott, MD

  • Surgery Physician
  • Greeley, CO
National Provider Identifier
1871122135
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR.0075462 Issued in CO
Practice address
1800 15TH St Ste 200
Greeley, CO 80631-4563
Phone
(970) 810-8216
Fax
(970) 810-5297
NPI assigned
Apr 7, 2020
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Surgery Physician 208600000X V6355 TX
Surgery Physician 208600000X DR.0075462 CO Primary

Addresses

Primary practice location

1800 15TH St Ste 200
Greeley, CO 80631-4563

Mailing address

1800 15TH St Ste 200
Greeley, CO 80631-4563
Phone (970) 810-8216

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
I20250717004472 CO Practitioner - General Surgery 9931615994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
George Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 15TH St
Suite 200
Greeley, CO 80631-4563
Phone (970) 810-8216

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0075462COMDSurgery Physician
V6355TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Aug 11, 2025 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 11, 2025 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

1800 15th St
Ste 200
Greeley, CO 80631
Phone (970) 348-0020

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

Organizations & group practices 3

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1871122135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 15TH ST STE 200",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314563",
            "telephone_number": "970-810-8216",
            "fax_number": "970-810-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 15TH ST STE 200",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314563",
            "telephone_number": "970-810-8216",
            "fax_number": "970-810-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRIOTT",
        "first_name": "CHARLES",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "V6355",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0075462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.