Randy Chadwell, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

105209-1206 Issued in UT

Practice address

2500 Canyon Rd BLDG B
Bullhead City, AZ 86442-8624

Phone

(928) 444-1491

Fax

(435) 787-1913

NPI assigned

Sep 7, 2006

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

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.8 of 100Reported as apm

Quality

77.6

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: randy.chadwell.1@1575.direct.athenahealth.com

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.

• Advanced Spine Pain Specialists

  • Pain Medicine Physician
  • Providence, UT
  • NPI 1285958439
  Medicare reassignment
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1295838605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD STE 1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428624",
            "telephone_number": "928-444-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD BLDG B",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428624",
            "telephone_number": "928-444-1491",
            "fax_number": "435-787-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADWELL",
        "first_name": "RANDY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "105209-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000012642",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "randy.chadwell.1@1575.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "2500 Canyon Rd Bldg B",
            "city": "Bullhead City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "864428624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Casper Teleradiology, PLLC (Casper Radiology)
• Virginia Ann Castaneda
• Lori Kay Casteel, REGISTERED NURSE
• Catholic Charities Community Services
• Alyssa Marie Cavazos, M.S., CCC-SLP
• Gayle Eileen Chance, PHARM D
• Paul Chang, D.D.S.
• Nina C Chase-Bouamoud, P.A.-C
• Childrens Medical Center of Bullhead City, PLLC
• Burhan F Chinikhanwala, MD

• Surgical Physician Assistant in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.