Thomas James Chitwood, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6001002-15 Issued in WI

Practice address

100 N Church St
Richland Center, WI 53581-2250

Phone

(608) 647-3993

NPI assigned

Jun 7, 2022

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 20, 2024 through Jun 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Williams & Pearce Family Dental SC

  • Dentist
  • Richland Center, WI
  • NPI 1861455016
  NPD (past)

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1659000461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N CHURCH ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535812250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N CHURCH ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535812250",
            "telephone_number": "608-647-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITWOOD",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001002-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Dennis Burns, CRNA
• Robin M Butrick, MD
• Center Optical, Inc.
• David E Chakoian, M.D.
• Andrea Kristin Cherry, PA-C
• Jessica Clark-Gomez
• Mary Jo Coleman
• Corcoran Healthcare ENT Inc
• Corcoran Healthcare Enterprises Inc
• Paul F Corcoran Jr.

• General Practice Dentistry in Richland Center, WI
• Providers in Richland Center, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.