Individual provider Active NPI

Chad Young McCready, PA-C

  • Physician Assistant
  • Coffeyville, KS
National Provider Identifier
1144794843
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1400 W 4TH St
Coffeyville, KS 67337-3306
Phone
(620) 251-1200
NPI assigned
Jan 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X KS Primary

Addresses

Primary practice location

1400 W 4TH St
Coffeyville, KS 67337-3306

Mailing address

1400 W 4TH St
Coffeyville, KS 67337-3306
Phone (620) 252-1639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190315001147 KS Practitioner - Physician Assistant 2163762865 Reassigns benefits to 1 organization
I20220506002232 OK Practitioner - Physician Assistant 2163762865 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
Williams Medical Group Practice, LLCGroup PAC ID 3375832157, 212 clinicians

Practice addresses (Care Compare)

1513 W Wyatt Erp Blvd
Dodge City, KS 67801-3352
Phone (620) 682-8304

220 S Van Buren St
Enid, OK 73703-5812
Phone (580) 234-9355

2215 N Hwy 64
Guymon, OK 73942-2750
Phone (580) 754-2280

231 S Andover Rd
Andover, KS 67002-7919
Phone (316) 733-9355

445 W 15TH St
Liberal, KS 67901-2464
Phone (620) 417-9012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Apr 28, 2022 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Apr 28, 2022 Accepting new patients
Williams Medical Group Practice, LLC Past Accepting new patients

Locations

231 S Andover Rd
Andover, KS 67002
Phone (316) 733-9355

1400 W 4th St
Coffeyville, KS 67337
Phone (620) 251-1200

445 W 15th St
Liberal, KS 67901
Phone (620) 417-9012

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

2215 N Highway 64
Guymon, OK 73942
Phone (580) 754-2280

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

701 Cedar Lake Blvd
Ste 120
Oklahoma City, OK 73114
Phone (405) 286-1170

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1144794843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-252-1639",
            "fax_number": "620-252-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-251-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREADY",
        "first_name": "CHAD",
        "middle_name": "YOUNG",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-15",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coffeyville, KS

Sources for this page

Verify at the official NPI Registry.