DR. CHARLES ROBERT PORTWOOD (NPI# 1689611576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689611576 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ROBERT PORTWOOD |
| Credential | D.C. |
| Practice Address |
310 W Losey St Scott Afb IL 62225-5250 |
| Mailing Address |
370 Stormyoak Dr Ballwin MO 63021-7448 |
| Practice Telephone | 6182566267 |
| Practice Fax Number | 6182567931 |
| Mailing Telephone | 6362300142 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 6006 | MO | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CHIROPRACTIC PHYSICIAN | OTH000 | 01 |
| Street Address |
310 W LOSEY ST |
| City | SCOTT AFB |
| State | IL |
| Zip Code | 62225-5250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839727 | Toney L Banks | Nurse Anesthetist, Certified Registered | 310 W Losey St, Scott Afb, IL 62225-5250 | 2005-05-30 |
| 1841814852 | Hilary Elizabeth Parsons | Student in an Organized Health Care Education/Training Program | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-06-04 |
| 1447874722 | Mauranda Nikki Bembry | Social Worker | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-06-03 |
| 1437778016 | Mark Alan Underhill | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-04-13 |
| 1194353276 | Kolin Daniel Cookson | Student in an Organized Health Care Education/Training Program | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-04-01 |
| 1831723592 | Linh Thuy Truong | Dentist | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-03-02 |
| 1346890894 | Crystal June Garcia | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-09-17 |
| 1740835602 | Andres Alejandro Paredes | Physician Assistant | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-08-07 |
| 1215580386 | Ryan Taylor Blalock | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-07-18 |
| 1063975001 | Collin Schroeder | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011645 | Cheryl D Jones | Registered Nurse | 375th Mdg, 310 W. Losey Street, Scott Afb, IL 62225 | 2020-04-13 |
| 1649836123 | Benjamin Truong | Student in an Organized Health Care Education/Training Program | Scott Air Force Base, 307 West Losey Street Building #1535, Apo, AA 62225 | 2019-05-10 |
| 1558925669 | Brian Ng | Student in an Organized Health Care Education/Training Program | South Drive, Scott Afb, Illinois, Apo, AA 62225 | 2019-04-24 |
| 1841853710 | Lance Scott Mcgavin | Student in an Organized Health Care Education/Training Program | 307 West Losey Street., Building #1535, Scott Afb, IL 62225 | 2019-04-17 |
| 1629503180 | Joshua Bryce Kessack | General Practice | 375 Amds, 310 Losey St, Scott Afb, IL 62225 | 2017-04-21 |
| 1265988059 | Jennifer Nicole Laurence | Dentist | 703 Seibert Rd Ste 5, Scott Afb, IL 62225 | 2016-08-31 |
| 1578940755 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 207 W. Winters St., Bldg 1981, Scott Afb, IL 62225 | 2015-04-27 |
| 1891193652 | Diana Meyer | Social Worker | Scott Afb, Apo, AA 62225 | 2014-12-10 |
| 1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
| 1487998746 | Melissa Dawn Goff | Military Health Care Provider | 310 West. Losey Street, Scott Afb, IL 62225 | 2012-11-26 |
| Find all providers in zip 62225 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861347 | Evan Charles Mojica | Chiropractor | 1803 W State St Ste 150, Geneva, IL 60134-3692 | 2020-11-06 |
| 1407454424 | Mikel Marshall | Chiropractor | 881 S Lorraine Rd Apt 103, Wheaton, IL 60189-6924 | 2020-10-12 |
| 1912505157 | David Anthony Wesdock | Chiropractor | 208 Parkinson St, Normal, IL 61761-3079 | 2020-10-10 |
| 1902403124 | Maranda Joe Humphreys | Chiropractor | 2150 Manchester Rd Ste 100, Wheaton, IL 60187-2474 | 2020-10-01 |
| 1023625654 | Kennedy Nicole Brauer | Chiropractor | 208 Flax Dr Ste 200, Highland, IL 62249-1394 | 2020-09-28 |
| 1649886730 | Simply Wellness Chiropractic, LLC | Chiropractor | 7117 Crimson Ridge Dr Ste 1, Rockford, IL 61107-6213 | 2020-09-23 |
| 1639785330 | Eve Marie Greenwell | Chiropractor | 143 N Henderson St, Mt Zion, IL 62549-1313 | 2020-09-17 |
| 1588279640 | Guadalupe Garcia | Chiropractor | 2745 Maple Ave Ste 2d, Lisle, IL 60532-3231 | 2020-09-14 |
| 1770197774 | Align Services Bloomington Pllc | Chiropractor | 2309 E Empire St Ste 200a, Bloomington, IL 61704-8636 | 2020-09-07 |
| 1881208080 | Christian James Koch | Chiropractor | 5100 N Ravenswood Ave Ste 107, Chicago, IL 60640-1710 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
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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.