Marisha E. Chilcott, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A88901 Issued in CA

Practice address

2800 Cleveland Ave
Santa Rosa, CA 95403-2783

Phone

(707) 800-7568

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marisha Erika Lockwood-Chilcott Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Family PracticeAlso: Hospitalist

Education

University of California, Davis School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlockwoodchilcott1657983@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Chilcott MD Inc

  • Infusion Therapy Clinic/Center
  • Santa Rosa, CA
  • NPI 1679237796
  NPD Authorized official
• Be the Change in Mental Health

  • Adult Mental Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1508441403
  NPD
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Chase Dennis Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Santa Rosa, CA
  • NPI 1033152350

  Family Medicine

  NPD (past)
• SRM Alliance Hospital Services

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

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

• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1174600985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032784",
            "telephone_number": "707-921-7447",
            "fax_number": "888-995-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032783",
            "telephone_number": "707-800-7568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Bon Air Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Larkspur",
            "state": "CA",
            "postal_code": "949391137",
            "country_code": "US",
            "telephone_number": "415-924-1330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILCOTT",
        "first_name": "MARISHA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A88901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISHA",
            "last_name": "LOCKWOOD-CHILCOTT",
            "middle_name": "ERIKA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deborah Lynn Chiddix, PSY.D.
• Elena Chieffo
• Deborah Ann Chigazola, RDHAP, MS
• Chilcott MD Inc
• Forrest Scott Chilcott Jr., MD
• Ullrike Johanna Childs
• Jerome Hsi-Cheng Chin, M.D. PH.D.
• Warren Bruce Chin, MD
• Regina L. Chinn, LCSW
• Chiropractic Neurology Enhancement Center

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.