Individual provider Active NPI

Chad Freeman Chaney, O.D.

  • Optometrist
  • Fort Payne, AL
National Provider Identifier
1083763049
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-A88-TA-657 Issued in AL
Practice address
1953 Gault Ave N
Fort Payne, AL 35967-3417
Phone
(256) 845-5555
Fax
(256) 997-9310
NPI assigned
Jan 9, 2007
Last updated
Jan 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-A88-TA-657 AL Primary

Addresses

Primary practice location

1953 Gault Ave N
Fort Payne, AL 35967-3417

Mailing address

1953 Gault Ave N
Fort Payne, AL 35967-3417
Phone (256) 845-5555

Other identifiers 2

IdentifierTypeStateIssuer
AL0657OtherALEYECARE PLAN OF AMERICA
5294250001OtherALPALMETTO GBA-DMERC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000517 AL Practitioner - Optometry 7012977507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California, Irvine, California College of Medicine, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1953 Gault Ave N
Fort Payne, AL 35967-3417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-A88-TA-657ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chaney Eye Care, L.L.C. Optometrist CurrentSince Aug 23, 2004 Accepting new patients

Locations

1953 Gault Ave N
Fort Payne, AL 35967
Phone (256) 845-2020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1083763049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673417",
            "telephone_number": "256-845-5555",
            "fax_number": "256-997-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673417",
            "telephone_number": "256-845-5555",
            "fax_number": "256-997-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "CHAD",
        "middle_name": "FREEMAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-A88-TA-657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYECARE PLAN OF AMERICA",
            "identifier": "AL0657",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-DMERC",
            "identifier": "5294250001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.