Individual provider Active NPI

Charlotte Anne Indeck, RN, BSN

  • Registered Nurse
  • Englewood, CO
National Provider Identifier
1881839017
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
80650 Issued in CO
Practice address
3425 S Clarkson St
Englewood, CO 80113-2811
Phone
(303) 761-5281
Fax
(303) 761-5282
NPI assigned
Dec 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 80650 CO Primary

Addresses

Primary practice location

3425 S Clarkson St
Englewood, CO 80113-2811

Mailing address

3425 S Clarkson St
Englewood, CO 80113-2811
Phone (303) 761-5281

Other identifiers 1

IdentifierTypeStateIssuer
841235373OtherBCBS

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
80650COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1881839017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132811",
            "telephone_number": "303-761-5281",
            "fax_number": "303-761-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132811",
            "telephone_number": "303-761-5281",
            "fax_number": "303-761-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDECK",
        "first_name": "CHARLOTTE",
        "middle_name": "ANNE",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "80650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "841235373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.