Evgeniya Nikolaevna Chisenhall, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2019-02047 Issued in NC

Practice address

120 Memorial Dr
Jacksonville, NC 28546

Phone

(910) 353-0581

Fax

(910) 577-1150

NPI assigned

May 13, 2016

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Columbus Regional Health Network

  dba Advanced Family Care

  • Hospitalist Physician
  • Whiteville, NC
  • NPI 1508001009
  Medicare reassignment NPD
• Jacksonville Children's and Multispecialty Clinic, PA

  • Family Medicine Physician
  • Jacksonville, NC
  • NPI 1164519070

  Pediatrics

  Medicare reassignment NPD
• Amm Healthcare, PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1528639689

  Pediatrics

  NPD
• Columbus Regional Health Network

  dba Advanced Orthopedics

  • Orthopaedic Surgery Physician
  • Whiteville, NC
  • NPI 1790224962
  NPD
• Columbus Regional Health Network

  dba Advanced Pediatrics & Family Care

  • Pediatrics Physician
  • Whiteville, NC
  • NPI 1851724645
  NPD
• Jacksonville Behavior and Mental Health

  • Adolescent and Children Mental Health Clinic/Center
  • Jacksonville, NC
  • NPI 1770771750
  NPD
• Columbus Regional Health Network

  dba Advanced Primary Care

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1518263268
  NPD (past)
• Family Care Clinic, P.a.

  • Clinic/Center
  • Jacksonville, NC
  • NPI 1316033590
  NPD (past)
• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Hope Mills, NC
  • NPI 1679529051
  NPD (past)

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1083060545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28546",
            "telephone_number": "910-353-0581",
            "fax_number": "910-577-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-744-2335",
            "fax_number": "252-744-3811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "28546",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISENHALL",
        "first_name": "EVGENIYA",
        "middle_name": "NIKOLAEVNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2019-02047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Chester, LCMHC-A
• Brittany Cheyne
• David Childers, DC
• Henry Chirino
• Katie Anne Chironna
• Madison Chisum
• Patricia E. Chisum, FNP-C
• Ulysess Choice Jr.
• Joseph Chorley, PHD
• Victoria Smith Christmas

• Pediatrics Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.

Verify at the official NPI Registry.