Active NPI
Choate Health Management Inc
- Psychiatry Physician
- Aiken, SC
National Provider Identifier
1023109790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- CHOATE HEALTH MANAGEMENT INC
- Practice address
- 655 Medical Park Drive
Aiken, SC 29802 - Phone
- (803) 641-5907
- Fax
- (803) 641-5907
- NPI assigned
- Sep 27, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bernice Wetzel
- Title
- Cfo
- Phone
- (610) 524-1552
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | NU | Primary |
Addresses
Primary practice location
655 Medical Park Drive
Aiken, SC 29802
Mailing address
367 S Gulph Rd
King of Prussia, PA 19406-3121
Phone (610) 524-1552
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP3028 | Medicaid | SC | |
| CJ9471 | Other | SC | RAILROAD MEDICARE |
| 0009439958 | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- Arbour Counseling Services Woburn
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Psychologist
- Lowell, MA
- NPI 1073674420
-
dba Arbour Counseling Services, Woburn
- Community/Behavioral Health Agency
- Woburn, MA
- NPI 1487873576
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Minneapolis, MN
- NPI 1710078258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1023109790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 S GULPH RD",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194063121",
"telephone_number": "610-524-1552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 MEDICAL PARK DRIVE",
"city": "AIKEN",
"state": "SC",
"postal_code": "29802",
"telephone_number": "803-641-5907",
"fax_number": "803-641-5907"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHOATE HEALTH MANAGEMENT INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WETZEL",
"authorized_official_first_name": "BERNICE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "610-524-1552"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP3028",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CJ9471",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009439958",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.