Active NPI
Michael A Chunn, MD
- Family Medicine Physician
- Mason, OH
National Provider Identifier
1043222896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35076823
- Practice address
- 6860 Tylersville Rd
Suite 12
Mason, OH 45040-1236 - Phone
- (513) 701-3145
- Fax
- (513) 701-3146
- NPI assigned
- Aug 12, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36326 | KY | |
| Family Medicine Physician | 207Q00000X | 35076823 | OH | Primary |
Addresses
Primary practice location
6860 Tylersville Rd
Suite 12
Mason, OH 45040-1236
Mailing address
6860 Tylersville Rd
Suite 12
Mason, OH 45040-1236
Phone (513) 701-3145
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2183686 | Medicaid | OH | |
| 311185270059 | Other | OH | HEALTH NET FEDERAL SERVIC |
| 000000530676 | Other | OH | ANTHEM BCBS |
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2023 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36326 | KY | MD | Family Medicine Physician |
| 35076823 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chunn Enterprises, Inc. | Family Medicine | Current | Accepting new patients |
| Renal Physicians Inc | Past | Accepting new patients | |
| Mvhe Inc | Past | Accepting new patients | |
| Miami Valley Emergency Specialists, LLC | Emergency Medicine | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
503 George McClain Dr
Benton, KY 42025
Phone (270) 527-4800
Interoperability endpoints
- michael.chunn@809764635213828.direct.elationemr.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Benton, KY
- NPI 1275662025
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Emergency Medicine Physician
- Dayton, OH
- NPI 1821189085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1043222896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6860 TYLERSVILLE RD",
"address_2": "SUITE 12",
"city": "MASON",
"state": "OH",
"postal_code": "450401236",
"telephone_number": "513-701-3145",
"fax_number": "513-701-3146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6860 TYLERSVILLE RD",
"address_2": "SUITE 12",
"city": "MASON",
"state": "OH",
"postal_code": "450401236",
"telephone_number": "513-701-3145",
"fax_number": "513-701-3146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNN",
"first_name": "MICHAEL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "36326",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35076823",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2183686",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET FEDERAL SERVIC",
"identifier": "311185270059",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000530676",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mason, OH
- Achint V Choksy, M.D.
- Rebecca Chou, PT
- Katherine Louise Christy
- Saba Atiq Chughtai, M.D.
- Chunn Enterprises Inc. (Chunn Family Medicine)
- Lauren Churchey, FNP-C
- Cincinnati Children's Hospital Medical Center
- Cincinnati Oriental Medicine Clinic
- Cincinnati Sportsmedicine and Orthopaedic Center, Inc.
- City of Mason Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.