Individual provider Active NPI

Joseph E Chase, MD

  • Family Medicine Physician
  • Kent, OH
National Provider Identifier
1104833789
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35039423 Issued in OH
Practice address
401 Devon PL
Suite 215
Kent, OH 44240-6482
Phone
(330) 673-9501
Fax
(330) 673-8204
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35039423 OH Primary

Addresses

Primary practice location

401 Devon PL
Suite 215
Kent, OH 44240-6482

Mailing address

401 Devon PL
Suite 215
Kent, OH 44240-6482
Phone (330) 673-9501

Other identifiers 1

IdentifierTypeStateIssuer
0324125MedicaidOH

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

LicenseStateTypeSpecialty
35039423OHMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1104833789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 DEVON PL",
            "address_2": "SUITE 215",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406482",
            "telephone_number": "330-673-9501",
            "fax_number": "330-673-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DEVON PL",
            "address_2": "SUITE 215",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406482",
            "telephone_number": "330-673-9501",
            "fax_number": "330-673-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35039423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0324125",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.