Charles Richard Chamblee Jr., D.MIN; M.DIV; L.A.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A1203022 Issued in AR

Practice address

11321 Interstate 30
Suite 304
Little Rock, AR 72209-7067

Phone

(501) 202-7587

Fax

(501) 202-7513

NPI assigned

Dec 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Arkansas Health Group

  • Psychiatry Physician
  • Bryant, AR
  • NPI 1871959874

  Professional

  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  • Obstetrics & Gynecology Physician
  • Arkadelphia, AR
  • NPI 1720417835
  NPD
• Arkansas Health Group

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1285979609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-202-7587",
            "fax_number": "501-202-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11321 INTERSTATE 30",
            "address_2": "SUITE 304",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097067",
            "telephone_number": "501-202-7587",
            "fax_number": "501-202-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLEE",
        "first_name": "CHARLES",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.MIN; M.DIV; L.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "A1203022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Chambers, MD
• Helen A. Chambers
• Jeffery T Chambers
• Loi Ann Chambers, LCSW
• Erin Chamberss
• Norma Katherine Chambless, RN
• Lauren Chambliss
• Patricia Champion
• Alice Chan
• Bobbie Chan, ANP

• Professional Counselor in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.

Verify at the official NPI Registry.