Robert Dean Chappell Jr., FNP-C
Individual provider Active NPI Family Nurse Practitioner · Brookhaven, MS
NPI 1104332808 · NPPES record last updated Dec 18, 2017
Key facts
- NPI
- 1104332808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CHAP-L0CQFA (MS)
- Practice address
- 1005 W Congress St
Brookhaven, MS 39601-2603 - Phone
- (601) 833-9388
- NPI assigned
- Dec 18, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bridging Community With Healthcare, LLC
Practice addresses (Care Compare)
1005 W Congress St
Brookhaven, MS 39601-2603
Phone (601) 833-9388
1007 W Congress St
Brookhaven, MS 39601-2603
Hospital & facility affiliations
- King'S Daughters Medical Center-Brookhaven
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180301001914 | MS | Practitioner - Nurse Practitioner | 3274894589 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHAP-L0CQFA | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King'S Daughters Medical Center | Current |
Accepting new patients | |
| Bridging Community With Healthcare, LLC | Current |
Accepting new patients | |
| King'S Daughters Medical Center | Current |
Accepting new patients | |
| Kings Daughters Medical Center | Current | Accepting new patients |
Locations
427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011
1007 W Congress St
Brookhaven, MS 39601
Phone (601) 833-9388
430 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-7455
1005 W Congress St
Brookhaven, MS 39601
Phone (601) 833-6333
Interoperability endpoints
- robert.chappell.1@29866.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CHAP-L0CQFA | MS | Yes |
Addresses
Primary practice location
1005 W Congress St
Brookhaven, MS 39601-2603
Mailing address
926 Sunflower LN SW
Brookhaven, MS 39601-1916
Phone (601) 754-6453
Other providers in Brookhaven, MS
- Amy Katheryn Case
- Kimberly Case
- Meghan Lynn Case
- Ryan Corey Case
- Amanda Chappell
- Paige V Chisolm
- Chloe'S Caring Hands Healthcare LLC
- Jeffrey G Clark
- Candice Nicole Cliburn
- Clint'S Pharmacy Inc
All providers in Brookhaven, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.