Active NPI
Chester Theo Royals Jr., M.D.
- Surgery Physician
- Douglas, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 072653 | Other | GA | MEDICAL LICENSE |
| 003150454A | Medicaid | GA |
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
Enrollment records 1
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
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
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CRH Physician Practices, LLC | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Douglas, GA
- NPI 1710046073
-
- Surgery Physician
- Waycross, GA
- NPI 1154794857
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Douglas, GA
- NPI 1760419527
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.