Active NPI
Tamerla Dawn Chavis, MD
- Neurological Surgery Physician
- Beaumont, TX
National Provider Identifier
1104824671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- H4230
- Practice address
- 755 N 11TH Street
Suite P5500
Beaumont, TX 77702 - Phone
- (409) 924-8111
- Fax
- (409) 924-8234
- NPI assigned
- Jul 8, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | H4230 | TX | Primary |
Addresses
Primary practice location
755 N 11TH Street
Suite P5500
Beaumont, TX 77702
Mailing address
755 N 11TH Street
Suite P5500
Beaumont, TX 77702
Phone (409) 924-8111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140066844 | Other | MEDICARE RR | |
| 030803301 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H4230 | TX | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicago Institute of Neurosurgery & Neuroresearch | Neurological Surgery | Past | Accepting new patients |
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.
-
- Neurological Surgery Physician
- Chicago, IL
- NPI 1326099391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1104824671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 N 11TH STREET",
"address_2": "SUITE P5500",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "77702",
"telephone_number": "409-924-8111",
"fax_number": "409-924-8234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 N 11TH STREET",
"address_2": "SUITE P5500",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "77702",
"telephone_number": "409-924-8111",
"fax_number": "409-924-8234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIS",
"first_name": "TAMERLA",
"middle_name": "DAWN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-08",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "TX",
"license": "H4230",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "140066844",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "030803301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.