Individual provider Active NPI

Charles L Hough Jr., D.C.

  • Chiropractor
  • Fountain Valley, CA
National Provider Identifier
1104919661
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
17196 Issued in CA
Practice address
11770 Warner Ave
Suite 122
Fountain Valley, CA 92708-2663
Phone
(714) 633-9532
NPI assigned
Oct 2, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 17196 CA Primary

Addresses

Primary practice location

11770 Warner Ave
Suite 122
Fountain Valley, CA 92708-2663

Mailing address

11770 Warner Ave
Suite 122
Fountain Valley, CA 92708-2663
Phone (714) 633-9532

Other identifiers 3

IdentifierTypeStateIssuer
DC17196OtherCHIROPRACTIC LICENSE
DC0171960OtherCABLUE SHIELD
BC666ZOtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081231000181 CA Practitioner - Chiropractic 2769544618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11770 Warner Ave
Suite 122
Fountain Valley, CA 92708-2660
Phone (714) 633-9532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
740OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hough Chiropractic Inc Chiropractor CurrentSince Jul 25, 2015 Accepting new patients
Hough Chiropractic Inc CurrentSince Mar 9, 2020 Accepting new patients

Locations

11770 Warner Ave
Ste 122
Fountain Valley, CA 92708
Phone (714) 633-9532

15520 Rockfield Blvd
Ste A200
Irvine, CA 92618

2034 N Broadway
Santa Ana, CA 92706
Phone (714) 633-9532

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1104919661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 WARNER AVE",
            "address_2": "SUITE 122",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082663",
            "telephone_number": "714-633-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 WARNER AVE",
            "address_2": "SUITE 122",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082663",
            "telephone_number": "714-633-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGH",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "17196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "DC17196",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "DC0171960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "BC666Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.