Individual provider Active NPI

Chesney Blythe Carroll

  • Gynecology Physician
  • Fishersville, VA
National Provider Identifier
1124504949
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
0110006237 Issued in VA
Practice address
39 Beam LN
Fishersville, VA 22939-2348
Phone
(540) 213-7750
Fax
(540) 213-7755
NPI assigned
Jul 15, 2018
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 0110006237 VA Primary

Addresses

Primary practice location

39 Beam LN
Fishersville, VA 22939-2348

Mailing address

PO Box 388
Fishersville, VA 22939-0388

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chesney.carrol.1@14718.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018002844 VA Practitioner - Physician Assistant 9830442953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

39 Beam LN
Fishersville, VA 22939-2348
Phone (540) 213-2636

53 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 332-5687

9 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 245-7350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.46 of 100Reported as apm
Quality
90.92
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006237VAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Medical Group CurrentSince Nov 4, 2024 Accepting new patients

Locations

540 Radford Ln
Ste 250
Charlottesville, VA 22903
Phone (434) 823-7596

39 Beam Ln
Fishersville, VA 22939
Phone (540) 213-7750

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

9 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 245-7350

240 Lucy Dr
Harrisonburg, VA 22801
Phone (540) 433-1041

644 University Blvd
Harrisonburg, VA 22801
Phone (540) 564-5100

30 Greenhouse Rd
Lexington, VA 24450
Phone (540) 464-3465

Interoperability endpoints

  • Direct secure messaging: chesney.carrol.1@14718.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1124504949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 BEAM LN",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392348",
            "telephone_number": "540-213-7750",
            "fax_number": "540-213-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CHESNEY",
        "middle_name": "BLYTHE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "0110006237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chesney.carrol.1@14718.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "address_1": "39 Beam Ln",
            "city": "Fishersville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229392348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.