Individual provider Active NPI

Kerry E Chamberlain, DO

  • Medical Oncology Physician
  • Largo, FL
National Provider Identifier
1073502233
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
OS5728 Issued in FL
Practice address
100 Highland Ave NE
Largo, FL 33770-2542
Phone
(727) 683-2900
Fax
(727) 683-2901
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X OS5728 FL
Medical Oncology Physician 207RX0202X OS5728 FL Primary

Addresses

Primary practice location

100 Highland Ave NE
Largo, FL 33770-2542

Mailing address

PO Box 102222
Attn; Credential Department
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
038215900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000077 FL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5799885828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology CurrentSince Feb 14, 2011 Accepting new patients
Oncology Physicians PA Medical Oncology Past Accepting new patients
Sun Coast Hospital Inc Past Accepting new patients
Largo Physician Group, LLC PastSince Nov 4, 2012 Accepting new patients

Locations

3253 N McMullen Booth Rd
Ste 100
Clearwater, FL 33761
Phone (727) 725-8102

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

100 Highland Ave N
Fl Cancer
Largo, FL 33770
Phone (727) 683-2900

100 Highland Ave N
Largo, FL 33770
Phone (727) 683-2900

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

8787 Bryan Dairy Rd
Seminole, FL 33777
Phone (727) 391-4758

1201 5th Ave N
Ste 505
St Petersburg, FL 33705
Phone (727) 821-0017

Organizations & group practices 4

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1073502233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "address_2": "ATTN; CREDENTIAL DEPARTMENT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE NE",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702542",
            "telephone_number": "727-683-2900",
            "fax_number": "727-683-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "KERRY",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "OS5728",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "OS5728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038215900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.