Individual provider Active NPI

Stephanie Rene Chapman, D.O.

  • Psychiatry Physician
  • St Simons Island, GA
National Provider Identifier
1124256714
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
71929 Issued in GA
Practice address
1331 Ocean Blvd Ste 103
St Simons Island, GA 31522-4237
Phone
(912) 268-0533
Fax
(833) 275-2056
NPI assigned
Jun 23, 2009
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 71929 GA Primary

Addresses

Primary practice location

1331 Ocean Blvd Ste 103
St Simons Island, GA 31522-4237

Mailing address

1331 Ocean Blvd Ste 103
St Simons Island, GA 31522-4237
Phone (912) 268-0533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
71929GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Simons Psychiatry, LLC Psychiatry CurrentSince Jan 15, 2023 Accepting new patients

Locations

1331 Ocean Blvd
Ste 103
St Simons Island, GA 31522
Phone (706) 509-3500

Interoperability endpoints

  • Direct secure messaging: stephanie.chapman.p1@direct.scdc.nextgenshare.com

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, 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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1124256714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 OCEAN BLVD STE 103",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224237",
            "telephone_number": "912-268-0533",
            "fax_number": "833-275-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 OCEAN BLVD STE 103",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224237",
            "telephone_number": "912-268-0533",
            "fax_number": "833-275-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "STEPHANIE",
        "middle_name": "RENE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "71929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Simons Island, GA

Sources for this page

Verify at the official NPI Registry.