Individual provider Active NPI

Chad Chenoweth, M.D.

  • General Practice Physician
  • Salt Lake City, UT
National Provider Identifier
1255620068
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
8436457-1205 Issued in UT
Practice address
1512 E 3115 S
Salt Lake City, UT 84106-3456
Phone
(801) 205-4112
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 8436457-1205 UT Primary

Addresses

Primary practice location

1512 E 3115 S
Salt Lake City, UT 84106-3456

Mailing address

1512 E 3115 S
Salt Lake City, UT 84106-3456
Phone (801) 205-4112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20171106001612 UT Practitioner - General Practice 3375773088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile MBS IncGroup PAC ID 0042357527, 2 clinicians

Practice addresses (Care Compare)

5691 S Shady Farm LN
Salt Lake City, UT 84107-6715
Phone (801) 590-8118

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.4 of 100Reported as group
Quality
48.33
Improvement activities
20
Cost
53.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile MBS Inc. CurrentSince Oct 10, 2017 Accepting new patients

Organizations & group practices 1

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": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1255620068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 E 3115 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063456",
            "telephone_number": "801-205-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 E 3115 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063456",
            "telephone_number": "801-205-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOWETH",
        "first_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "UT",
            "license": "8436457-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.