Individual provider Active NPI

Chester Theo Royals Jr., M.D.

  • Surgery Physician
  • Douglas, GA
National Provider Identifier
1194974816
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
100 Doctors Dr Ste C
Douglas, GA 31533-2211
Phone
(912) 384-5832
Fax
(912) 383-8279
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0 GA Primary

Addresses

Primary practice location

100 Doctors Dr Ste C
Douglas, GA 31533-2211

Mailing address

1100 Ward Street Ext W
Douglas, GA 31533-1902

Other practice location 1

204 E 15th St
Alma, GA 31510-2908
Phone (912) 384-5832

Other identifiers 2

IdentifierTypeStateIssuer
072653OtherGAMEDICAL LICENSE
003150454AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20141119001943 GA Practitioner - General Surgery 1254553613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Mercer University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

100 Doctors Dr
Douglas, GA 31533-2211

1101 Ocilla Rd
Douglas, GA 31533-2207

1508 Tebeau St
Waycross, GA 31501-5327
Phone (912) 384-5832

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
CRH Physician Practices, LLC CurrentSince Sep 1, 2014 Accepting new patients
CRH Physician Practices LLC Surgery Past Accepting new patients

Locations

204 E 15th St
Alma, GA 31510
Phone (912) 632-2952

100 Doctors Dr
Ste B
Douglas, GA 31533
Phone (912) 384-4121

1100 Ward Street Ext W
Douglas, GA 31533
Phone (912) 384-1470

100 Doctors Dr
Ste C
Douglas, GA 31533
Phone (912) 383-9789

1508 Tebeau St
Waycross, GA 31501
Phone (912) 383-6575

Interoperability endpoints

  • Direct secure messaging: chet.royals.1@9964.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194974816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WARD STREET EXT W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315331902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE C",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-384-5832",
            "fax_number": "912-383-8279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 E 15th St",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "GA",
            "postal_code": "315102908",
            "country_code": "US",
            "telephone_number": "912-384-5832",
            "fax_number": "912-383-8279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROYALS",
        "first_name": "CHESTER",
        "middle_name": "THEO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "072653",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003150454A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.