Keith Gregory Chisholm, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME83998 Issued in FL

Practice address

10751 Maple Creek Dr
Suite 103
Trinity, FL 34655-4418

Phone

(727) 372-0400

Fax

(727) 372-0403

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of North Carolina at Chapel Hill School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Trinity Hospital Hospital, Trinity, FL, CCN 100191
• Morton Plant North Bay Hospital Hospital, New Port Richey, FL, CCN 100063

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (1 of 3)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGDBBD/Endpoint/IGDBBD

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.

• Surgical Specialists of Trinity, PA

  • Surgery Physician
  • Trinity, FL
  • NPI 1982968541

  FL, Surgery

  Medicare reassignment NPD Authorized official

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

• Morton Plant Hospital Association Inc

  • General Acute Care Hospital
  • New Port Richey, FL
  • NPI 1437135811

  Hospital

  Care Compare affiliation
• New Port Richey Hospital Inc

  • General Acute Care Hospital
  • Trinity, FL
  • NPI 1891741849

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1164520375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 LITTLE RD",
            "address_2": "SUITE 311",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551864",
            "telephone_number": "727-372-0400",
            "fax_number": "727-372-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10751 MAPLE CREEK DR",
            "address_2": "SUITE 103",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554418",
            "telephone_number": "727-372-0400",
            "fax_number": "727-372-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "KEITH",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME83998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hetul Chaudhari, M.B.B.S
• Juliane Chavez
• Megha Chawla, MD
• Holly P Chery
• Chidambaram Chinniah, MD
• Judy Lynn Chissell, RN
• Mamta Tarak Choksi, M.D.
• Tarak Suman Choksi, MD
• Jayadeva Chowdappa, MD
• Bianca Christmann, APRN

• All providers in Trinity, FL
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.