Faith Pauline Chisum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A98040 Issued in CA

Practice address

949 Palm Ave
Imperial Beach, CA 91932-1503

Phone

(619) 429-3733

Fax

(619) 429-3823

NPI assigned

Aug 16, 2007

Sex

Female

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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBEEDD
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10012052
• Direct secure messaging: faithchisum@ibcc.allscriptsdirect.net

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.

• Imperial Beach Community Clinic

  • Community Health Clinic/Center
  • Imperial Beach, CA
  • NPI 1790718351
  Medicare reassignment NPD
• Imperial Beach Community Clinic

  • Community Health Clinic/Center
  • San Diego, CA
  • NPI 1215246996
  NPD

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1346432069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 PALM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321503",
            "telephone_number": "619-429-3733",
            "fax_number": "619-429-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 PALM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321503",
            "telephone_number": "619-429-3733",
            "fax_number": "619-429-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISUM",
        "first_name": "FAITH",
        "middle_name": "PAULINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A98040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ca Reliable Medical Syst Inc
• Heather Ann Roberts Calzada
• Andrew Jerrod Campbell
• Mirna Canizalez
• Andres Felipe Casallas, DDS
• Peter Inseok Chung, PT, DPT, CSCS
• James Christopher Clifford, M.D.
• Cochrane Medical Group, Inc
• Ruth Ann Cole, HHP, ABT, MT
• Luis Alberto Contreras, DDS

• Family Medicine Physician in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.