Individual provider Active NPI

Chantelle Radmila Dishon, AU.D

  • Audiologist
  • Glen Burnie, MD
National Provider Identifier
1225204076
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
01146 Issued in MD
Practice address
802 Landmark Dr. Ste 119
Glen Burnie, MD 21061
Phone
(410) 760-8840
Fax
(410) 367-2464
NPI assigned
May 1, 2008
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01146 MD Primary

Addresses

Primary practice location

802 Landmark Dr. Ste 119
Glen Burnie, MD 21061

Mailing address

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone (410) 760-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131023000714 MD Practitioner - Qualified Audiologist 9335374693 Reassigns benefits to 1 organization
I20140305001225 DC Practitioner - Qualified Audiologist 9335374693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11085 Little Patuxent Pkwy
Suite 101
Columbia, MD 21044-2914
Phone (410) 760-8840

14201 Laurel Park Dr
Suite 115
Laurel, MD 20707-5203
Phone (410) 760-8840

Merit-based Incentive Payment System (MIPS)

Final score
82.02 of 100Reported as group
Quality
65.13
Promoting interoperability
98
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01146MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Regional Physicians LLC Audiologist Current Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Nov 1, 2017 Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Nov 1, 2017 Accepting new patients

Locations

129 Lubrano Dr
Ste L100
Annapolis, MD 21401
Phone (240) 274-1377

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

11085 Little Patuxent Pkwy
Ste 101
Columbia, MD 21044
Phone (410) 997-7979

203 Hospital Dr
Ste 200
Glen Burnie, MD 21061
Phone (410) 553-8362

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone 4107608840203

14201 Laurel Park Dr
Ste 115
Laurel, MD 20707
Phone (301) 490-8083

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

Interoperability endpoints

  • Direct secure messaging: cgordontennant799037@direct.hopkinsmedicine.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1225204076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR",
            "address_2": "STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR. STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8840",
            "fax_number": "410-367-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISHON",
        "first_name": "CHANTELLE",
        "middle_name": "RADMILA",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.