Individual provider Active NPI

Michael A Chunn, MD

  • Family Medicine Physician
  • Mason, OH
National Provider Identifier
1043222896
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35076823 Issued in OH
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

Updated by the provider on Jan 27, 2020

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 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

IdentifierTypeStateIssuer
2183686MedicaidOH
311185270059OtherOHHEALTH NET FEDERAL SERVIC
000000530676OtherOHANTHEM 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
Green means eligible to order or refer.
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36326KYMDFamily Medicine Physician
35076823OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: 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.

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

Sources for this page

Verify at the official NPI Registry.