Active NPI
Michael Scott Chitwood Sr., MHP
- Prevention Professional
- Rock Island, IL
National Provider Identifier
1982305173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- XXXXXXX
- Practice address
- 1317 3Rd Ave
Rock Island, IL 61201-8562 - Phone
- (309) 794-1230
- NPI assigned
- Mar 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | XXXXXXX | IA | Primary |
Addresses
Primary practice location
1317 3Rd Ave
Rock Island, IL 61201-8562
Mailing address
2200 3Rd Ave
Rock Island, IL 61201-8840
Phone (309) 779-2094
Other practice location 1
2200 3rd Ave
Rock Island, IL 61201-8840
Phone (309) 779-2094
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XXXXXXX | IA | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1982305173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 3RD AVE",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612018840",
"telephone_number": "309-779-2094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 3RD AVE",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612018562",
"telephone_number": "309-794-1230"
}
],
"practiceLocations": [
{
"address_1": "2200 3rd Ave",
"address_purpose": "LOCATION",
"city": "Rock Island",
"state": "IL",
"postal_code": "612018840",
"country_code": "US",
"telephone_number": "309-779-2094",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHITWOOD",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "MHP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-14",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "IA",
"license": "XXXXXXX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.