CHARLES J. ZELLER III (NPI# 1114960820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114960820 |
| Entity Type | Individual |
| Full Name | CHARLES J. ZELLER III |
| Credential | DO |
| Practice Address |
1045 Channingway Dr. Fairborn OH 45324-9244 |
| Mailing Address |
2110 Leiter Rd Miamisburg OH 45342-3660 |
| Practice Telephone | 9378788644 |
| Practice Fax Number | 9378788646 |
| Mailing Telephone | 9373844838 |
| Mailing Fax Number | 9373844845 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34.002882 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0627147 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720086366 | Charles J Zeller Iv | Otolaryngology | 1601 S Andrews Ave Fl 3, Fort Lauderdale, FL 33316-2509 | 2005-07-08 |
| 1457465734 | Charles Leroy Zeller Jr. | Emergency Medicine | 125 S Kalamazoo Mall, Suite 204, Kalamazoo, MI 49007-4832 | 2006-08-17 |
| Street Address |
1045 CHANNINGWAY DR. |
| City | FAIRBORN |
| State | OH |
| Zip Code | 45324-9244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023647591 | Michael Hubbell | Student in an Organized Health Care Education/Training Program | 2555 University Blvd., Fairborn, OH 45324 | 2020-04-06 |
| 1982243382 | Wickshire Fairborn Opco LLC | Assisted Living Facility | 2270 Park Hills Drive, Fairborn, OH 45324 | 2020-01-02 |
| 1104301654 | Sophia Alridge | Counselor | 594 East Dayton Yellow Springs Road, Fairborn, OH 45324 | 2018-10-01 |
| 1750863189 | Sydney Bowser | Behavior Technician | 1750 Commerce Center Blvd., Fairborn, OH 45324 | 2018-09-01 |
| 1710406798 | Chester Cashmir Torkornoo | Dentist | 3989 Colonel Glenn Hwy A, Fairborn, OH 45324 | 2017-09-11 |
| 1245772375 | Ranada LLC | Health Maintenance Organization | 17 Vanderbilt Drive Apt G, Fairborn, OH 45324 | 2016-11-07 |
| 1194277582 | Derrick Bark | Specialist/Technologist | 85 Old Yellow Springs Rd, Fairborn, OH 45324 | 2016-11-01 |
| 1326592635 | Sheena Elizabeth Geoghegan | Student in an Organized Health Care Education/Training Program | 725 Univerisity Blvd., Wright State Physicians, Fairborn, OH 45324 | 2016-08-04 |
| 1912360199 | Tarah Heath | Occupational Therapist | 2498 Dayton, Beavercreek, OH 45324 | 2016-04-04 |
| 1255706339 | Cierra Jackson | Counselor | 1560 Calder Ct, Fairborn, OH 45324 | 2015-12-01 |
| Find all providers in zip 45324 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063798395 | Greene Memorial Hospital Services, Inc | Family Medicine | 1145 Channingway Dr, Fairborn, OH 45324-9244 | 2011-11-01 |
| 1225294176 | Darci Lavonne Brown | Family Medicine | 1045 Channingway Dr, Fairborn, OH 45324-9252 | 2008-07-30 |
| 1629006903 | Dan F Bautista | Family Medicine | 1840 Commerce Center Blvd, Fairborn, OH 45324-6337 | 2006-06-28 |
| 1548224579 | Fairborn Family Practice Assoc | Family Medicine | 850 E Xenia Drive, Suite 600, Fairborn, OH 45324-8760 | 2006-04-14 |
| 1932172467 | Jacob Thomas Dean | Family Medicine | 7790 Dayton Rd, Suite B, Fairborn, OH 45324-1442 | 2006-02-07 |
| 1912970468 | Western Medicine, Inc. | Family Medicine | 7774 Dayton Springfield Rd, Fairborn, OH 45324-1957 | 2006-02-07 |
| 1053758441 | Stefanie Kristine Lewis | Family Medicine | 1045 Channingway Dr, Fairborn, OH 45324-9252 | 2013-05-27 |
| 1437386083 | Christina L Bereda | Family Medicine | 2131 Gateway Dr, Fairborn, OH 45324-6357 | 2009-06-22 |
| 1730366378 | Adil M Ansari | Family Medicine | 7790 Dayton Rd, Suite B, Fairborn, OH 45324 | 2008-01-25 |
| 1780899633 | Geetha C Ambalavanan | Family Medicine | 2180 Gateway Dr, Fairborn, OH 45324-6356 | 2007-05-14 |
| Find all providers in FAIRBORN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.