Organization Active NPI

David H Chansolme MD PC

  • Infectious Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1245440056
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
23723 Issued in OK
Legal business name
DAVID H CHANSOLME MD PC
Practice address
4221 S Western Ave
Suite 4010
Oklahoma City, OK 73109-3447
Phone
(405) 644-6464
Fax
(405) 644-6465
NPI assigned
May 23, 2007
Last updated
Mar 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
David H Chansolme, MDNPI 1457343402
Title
President
Phone
(405) 644-6464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 23723 OK Primary

Addresses

Primary practice location

4221 S Western Ave
Suite 4010
Oklahoma City, OK 73109-3447

Mailing address

PO Box 720486
Norman, OK 73070-4357
Phone (405) 644-6464

Other identifiers 1

IdentifierTypeStateIssuer
200033350AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000603 OK Part B Supplier - Clinic/Group Practice 4688644800 Receives reassigned benefits from 4 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

5500 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 605-4140

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1245440056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720486",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704357",
            "telephone_number": "405-644-6464",
            "fax_number": "405-644-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE",
            "address_2": "SUITE 4010",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093447",
            "telephone_number": "405-644-6464",
            "fax_number": "405-644-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID H CHANSOLME MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "CHANSOLME",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-644-6464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OK",
            "license": "23723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200033350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.