Individual provider Active NPI

Theodosis J Chronis, DO

  • Family Medicine Physician
  • Pendleton, IN
National Provider Identifier
1023712403
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02008775A Issued in IN
Practice address
75 Village Dr
Pendleton, IN 46064-8960
Phone
(765) 778-0913
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02008775A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

75 Village Dr
Pendleton, IN 46064-8960

Mailing address

611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1468
Phone (574) 335-6500

Other practice location 1

611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1468
Phone (574) 335-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601002593 IN Order and Referring Only - Family PracticePractitioner - Family Practice 0446617609

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Marian University College of Osteopathic Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: tchronis2366378@direct.trinity-health.org

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1023712403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 407",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "574-335-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VILLAGE DR",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460648960",
            "telephone_number": "765-778-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 E Douglas Rd Ste 407",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465451468",
            "country_code": "US",
            "telephone_number": "574-335-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRONIS",
        "first_name": "THEODOSIS",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02008775A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, IN

Sources for this page

Verify at the official NPI Registry.