Individual provider Active NPI

Charlie Phares, DC

  • Chiropractor
  • Cumberland, MD
National Provider Identifier
1497109920
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S04024 Issued in MD
Practice address
203 Greene St
Cumberland, MD 21502-2877
Phone
(301) 777-0110
NPI assigned
Apr 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12009 FL
Chiropractor 111N00000X 4613 OH
Chiropractor 111N00000X 04024 MD
Chiropractor 111N00000X S04024 MD Primary

Addresses

Primary practice location

203 Greene St
Cumberland, MD 21502-2877

Mailing address

203 Greene St
Cumberland, MD 21502-2877
Phone (386) 846-2045

Other practice location 1

1906 W Platt St
Tampa, FL 33606-1709
Phone (813) 463-8355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621000691 MD Practitioner - Chiropractic 6002191681 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

203 Greene St
A
Cumberland, MD 21502-2877
Phone (301) 777-0110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009FLMDMental Health Counselor
04024MDMDClinical Psychologist
S04024MDMDChiropractor
4613OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Ridge Chiropractic, LLC Chiropractor CurrentSince May 25, 2021 Accepting new patients
Phares Chiropractic LLC CurrentSince Jan 1, 2024 Accepting new patients
Spring Ridge Chiropractic of Boonsboro LLC Chiropractor CurrentSince Sep 2, 2022 Accepting new patients
Audie G. Klingler DC Chiropractor PastSince Dec 22, 2024 Accepting new patients
Steller Life Care Inc. Chiropractor Past Accepting new patients

Locations

20311 Lappans Rd
Ste 102
Boonsboro, MD 21713
Phone (301) 620-8566

9093 Ridgefield Dr
Ste 107
Frederick, MD 21701
Phone (301) 620-8566

9093 Ridgefield Dr
Ste 106
Frederick, MD 21701
Phone (301) 620-8566

Organizations & group practices 5

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1497109920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 GREENE ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022877",
            "telephone_number": "386-846-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 GREENE ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022877",
            "telephone_number": "301-777-0110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 W Platt St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336061709",
            "country_code": "US",
            "telephone_number": "813-463-8355",
            "fax_number": "740-888-1856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHARES",
        "first_name": "CHARLIE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "12009",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4613",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "04024",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S04024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.