NPIMap

Organization Active NPI

College Park Medicine,PA

  • Family Medicine Physician
  • The Woodlands, TX
National Provider Identifier
1295815959
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COLLEGE PARK MEDICINE,PA
Practice address
17191 St Lukes Way Ste 200
The Woodlands, TX 77384-8043
Phone
(936) 271-2555
Fax
(936) 271-2557
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Authorized official

Name
Christopher Chapman, MDNPI 1164426888
Title
Medical Director
Phone
(936) 271-2555

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

17191 St Lukes Way Ste 200
The Woodlands, TX 77384-8043

Mailing address

17191 St Lukes Way Ste 200
The Woodlands, TX 77384-8043
Phone (936) 271-2555

Other practice location 1

5834 Louetta Rd Ste F
Spring, TX 77379-7884
Phone (832) 698-4291

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050413000255 TX Part B Supplier - Clinic/Group Practice 7113964966 Receives reassigned benefits from 16 practitioners
Practice locations: Spring, TX; Conroe, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1038316College Park Medicine PA17191 St Luke'S Way, Ste 200, The Woodlands, TX 77384Certificate of waiverMar 15, 2027
45D2028799College Park Medicine, PA5834 Louetta Suite F, Spring, TX 77379Certificate of waiverAug 23, 2027

National Provider Directory

National Provider Directory

Locations

690 S Loop 336 W
Ste 140
Conroe, TX 77304
Phone (936) 441-0046

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1295815959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17191 ST LUKES WAY STE 200",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773848043",
            "telephone_number": "936-271-2555",
            "fax_number": "936-271-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17191 ST LUKES WAY STE 200",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773848043",
            "telephone_number": "936-271-2555",
            "fax_number": "936-271-2557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5834 Louetta Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773797884",
            "country_code": "US",
            "telephone_number": "832-698-4291",
            "fax_number": "832-698-4297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLEGE PARK MEDICINE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "936-271-2555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.