Charles R Ford, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD10654 Issued in OR

Practice address

1815 E 19TH St
Suite 1
The Dalles, OR 97058-3385

Phone

(541) 298-5563

Fax

(541) 298-7746

NPI assigned

Sep 25, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1871693283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E 19TH ST",
            "address_2": "SUITE 1",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583385",
            "telephone_number": "541-298-5563",
            "fax_number": "541-298-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E 19TH ST",
            "address_2": "SUITE 1",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583385",
            "telephone_number": "541-298-5563",
            "fax_number": "541-298-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD10654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064899",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "1313907",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00139667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS OF OR",
            "identifier": "831523001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariana Noelle Fitzpatrick, PHARMD
• Caitlin Maureen Fitzpatrick
• Sean Malone Fitzpatrick, RPH; PHARM.D.
• Dawnel Flaherty
• Rosa Maria Flores Mendiola
• David Christain Ford, MD
• Alice Myra Forsythe, MD
• Mica Vonne Foster, DC
• Kristen Colleen McCaffrey Fourcade, MSW, LCSW
• Rebecca Diane Fox, RN, MSN

• Otolaryngology Physician in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Otolaryngology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; 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.