Jennifer S. Chadwell, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7004 Issued in KY

Practice address

325 Richmond Street
Mount Vernon, KY 40456-2712

Phone

(606) 256-5812

Fax

(606) 256-3748

NPI assigned

Jan 4, 2012

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1194095398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404560687",
            "telephone_number": "606-256-5812",
            "fax_number": "606-256-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 RICHMOND STREET",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404562712",
            "telephone_number": "606-256-5812",
            "fax_number": "606-256-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADWELL",
        "first_name": "JENNIFER",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60070042",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mount Vernon, KY
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.