Charles Justin Wood

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

509 Hamacher St Ste 101
Waterloo, IL 62298-1592

Phone

(618) 939-5555

NPI assigned

Dec 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCM Rehabilitation LLCGroup PAC ID 5294798336, 58 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.7 of 100Reported as group

Quality

90

Improvement activities

40

Cost

73.99

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1584/brand/1/csg/49/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MCM Rehabilitation, LLC.

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1538226840

  GA, Physical Therapist

  Medicare reassignment Care Compare group NPD
• MCM Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Hixson, TN
  • NPI 1922681360
  NPD

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1023614401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 HAMACHER ST STE 101",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981592",
            "telephone_number": "618-939-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CHARLES",
        "middle_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ellen Wilson, MAQMHP
• Alayna Wirth
• Shanna Witges, APRN NP-C
• Diana Wittenbrink, MHP
• Wonder Works Pediatric Therapy P.C.
• Glenn Woodcock, RSA
• Taylor Nicole Woods, MHP
• Peggy Ann Work, MHP
• Phyliss Yount, RSA

• Physical Therapist in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.