Douglas Allan Charlesworth

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01036465A Issued in IN

Practice address

2104 W Saybrook Dr
Goshen, IN 46528-5709

Phone

(574) 534-4023

NPI assigned

Aug 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508875071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 W SAYBROOK DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465285709",
            "telephone_number": "574-534-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 W SAYBROOK DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465285709",
            "telephone_number": "574-534-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLESWORTH",
        "first_name": "DOUGLAS",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01036465A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roel Cervantes, LMHCA
• CFH, LLC (Caring for Hoosiers)
• Julia Chairez, FNP-BC
• Rebecca Chalfant, DNP
• Change Architects LLP
• Maritza E Chavez Stahly, LAT, ATC
• Casilda Cabral Chenier, PA
• Winfield Alfred Chester, MSW, LSW
• Chiropractic Wellness Center of Goshen, PC
• Janelle E Christensen, MSW

• Family Medicine Physician in Goshen, IN
• Providers in Goshen, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.