Active NPI
Jim A Chitmon, COF
- Orthotic Fitter
- Greenville, NC
National Provider Identifier
1053419101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- 02771
- Practice address
- 615 B South Memorial Dr
Greenville, NC 27834 - Phone
- (252) 752-0338
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | 02771 | NC | Primary |
Addresses
Primary practice location
615 B South Memorial Dr
Greenville, NC 27834
Mailing address
615 B South Memorial Dr
Greenville, NC 27834
Phone (252) 752-0338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7795256 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02771 | NC | MD | Orthotic Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053419101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 B SOUTH MEMORIAL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27834",
"telephone_number": "252-752-0338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 B SOUTH MEMORIAL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27834",
"telephone_number": "252-752-0338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHITMON",
"first_name": "JIM",
"middle_name": "A",
"credential": "COF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "NC",
"license": "02771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795256",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.