CHARLYN FARGO WARE (NPI# 1174934269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174934269 |
| Entity Type | Individual |
| Full Name | CHARLYN FARGO WARE |
| Credential | MS RD LDN |
| Practice Address |
751 N Rutledge St Ste 3100 Springfield IL 62702-4968 |
| Mailing Address |
2115 S Macarthur Blvd Springfield IL 62704-4501 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2177261001 |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-02-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 164.001664 | IL | Dietary & Nutritional Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2115 S Macarthur Blvd, Springfield, IL 627044501 | 2177261001 |
| Street Address |
751 N RUTLEDGE ST STE 3100 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154513687 | Fazeel Mukhtar Siddiqui | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2007-08-17 |
| 1578112363 | Amanda Graham | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2019-09-05 |
| 1912562109 | Katie D Hartman | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2019-05-03 |
| 1528440724 | Jordan Leigh Sestak | Internal Medicine | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2015-06-24 |
| 1811322209 | Nicole Lynn Atwood | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2013-09-04 |
| 1184979551 | Bilal Butt | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702 | 2012-07-20 |
| 1043520869 | Jacob M Monsivais | Physician Assistant | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2010-10-14 |
| 1669784559 | Hesham A Allam | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2010-07-08 |
| 1790923951 | Nassir Hassan Monim Mansour | Neurological Surgery | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2009-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716832 | Anna Opalko | Dietitian, Registered | 504 Philmar Ct Apt B, Springfield, PA 19064-3065 | 2020-10-05 |
| 1659978641 | Jaimie Lillian Lafferty | Dietitian, Registered | 1033 Lincoln Ave, Springfield, PA 19064-3922 | 2020-10-03 |
| 1023626108 | Samuel Bryan Yarrow | Dietitian, Registered | 960 E Walnut Lawn St Ste 203, Springfield, MO 65807-7865 | 2020-07-15 |
| 1417572579 | Nikki Jupe | Dietitian, Registered | 1928 5th St Apt 27, Springfield, OR 97477-2291 | 2020-06-14 |
| 1205487337 | Mary Digioia | Dietitian, Registered | 66 Industry Ave Ste 9, Springfield, MA 01104-3243 | 2019-09-20 |
| 1144877556 | Lindsey Allison Mcclafferty | Dietitian, Registered | 3252 S Meadowlark Ave, Springfield, MO 65807-8719 | 2019-08-20 |
| 1891357125 | Amy Richter | Dietitian, Registered | 1857 S Hampton Ave, Springfield, MO 65807-2725 | 2019-07-08 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1407322407 | Ruth Kirschner | Dietitian, Registered | 275 Chestnut St Ste 1, Springfield, MA 01104-3498 | 2018-10-17 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.