Individual provider Active NPI

Chad Allen Rhoden, MD

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1043387764
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18656 Issued in MS
Practice address
3502 W Northside Dr
Jackson, MS 39213-4454
Phone
(601) 362-5321
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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 18656 MS Primary
Emergency Medicine Physician 207P00000X 18656 MS

Addresses

Primary practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Mailing address

3502 W Northside Dr
Jackson, MS 39213-4454
Phone (601) 362-5321

Other identifiers 1

IdentifierTypeStateIssuer
05126830MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070205000648 MS Practitioner - Emergency MedicinePractitioner - Family PracticePractitioner - Preventive Medicine 9931101995 Reassigns benefits to 4 organizations
I20161019002207 GA Practitioner - Emergency Medicine 9931101995 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Dec 20, 2017 Accepting new patients
Attala Emergency Group LLC Emergency Medicine CurrentSince Mar 25, 2015 Accepting new patients
Keystone Medical Services of Ms, Inc Emergency Medicine CurrentSince Mar 23, 2016 Accepting new patients
App of Mississippi Ed, LLC Emergency Medicine CurrentSince Mar 12, 2018 Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Sep 6, 2016 Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Sep 6, 2016 Accepting new patients
Trustcare Primary Care, LLC Family Medicine Past Accepting new patients
Madison Hma Physician Management LLC Past Accepting new patients

Locations

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

220 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-4311

54 Sgt Prentiss Dr
Natchez, MS 39120
Phone (601) 443-2100

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1043387764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODEN",
        "first_name": "CHAD",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18656",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "18656",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05126830",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.