Active NPI
Matthew David Chappell, PA
- Physician Assistant
- Ft. Rucker, AL
National Provider Identifier
1053995308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1183045
- Practice address
- 301 Andrews Ave
Ft. Rucker, AL 36362 - Phone
- (334) 255-3853
- NPI assigned
- May 11, 2021
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1183045 | Primary |
Addresses
Primary practice location
301 Andrews Ave
Ft. Rucker, AL 36362
Mailing address
103 Glenfinnan Way
Dothan, AL 36305-6983
Phone (571) 386-7292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781827200000",
"number": "1053995308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 GLENFINNAN WAY",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363056983",
"telephone_number": "571-386-7292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 ANDREWS AVE",
"city": "FT. RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-3853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAPPELL",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-11",
"last_updated": "2026-06-19",
"certification_date": "2026-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1183045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ft. Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.