Individual provider Active NPI

Caleb Hunter Chesnut, OD

  • Optometrist
  • Evansville, IN
National Provider Identifier
1356073662
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004331A Issued in IN
Practice address
634 Cross Valley Cir
Evansville, IN 47710-5238
Phone
(812) 401-7777
Fax
(812) 429-0392
NPI assigned
Jun 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004331B IN
Optometrist 152W00000X 18004331A IN Primary

Addresses

Primary practice location

634 Cross Valley Cir
Evansville, IN 47710-5238

Mailing address

634 Cross Valley Cir
Evansville, IN 47710-5238
Phone (812) 401-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718000331 IN Practitioner - Optometry 3072994482 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Oakland City Eyecare, LLCGroup PAC ID 1850301383, 5 clinicians
Northside Eyecare Associates, LLCGroup PAC ID 3678615259, 5 clinicians
South Gibson Eyecare Associates, LLCGroup PAC ID 2769657063, 5 clinicians

Practice addresses (Care Compare)

110 N Main St
Oakland City, IN 47660-1329

110 N Main St
Oakland City, IN 47660-1502
Phone (812) 749-3700

634 Cross Valley Cir
Evansville, IN 47710-5238
Phone (812) 401-7777

831 S 9TH Ave
Haubstadt, IN 47639-8244
Phone (812) 615-0277

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004331AINMDOptometrist
18004331BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South Gibson Eyecare Associates, LLC Optometrist CurrentSince Jul 1, 2022 Accepting new patients
Oakland City Eyecare, LLC Optometrist CurrentSince Jul 1, 2022 Accepting new patients
Northside Eyecare Associates, LLC Optometrist CurrentSince Jul 1, 2022 Accepting new patients

Locations

634 Cross Valley Cir
Evansville, IN 47710
Phone (812) 401-7777

831 S 9th Ave
Haubstadt, IN 47639
Phone (812) 615-0277

110 N Main St
Oakland City, IN 47660
Phone (812) 749-3700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1356073662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 CROSS VALLEY CIR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105238",
            "telephone_number": "812-401-7777",
            "fax_number": "812-429-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 CROSS VALLEY CIR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105238",
            "telephone_number": "812-401-7777",
            "fax_number": "812-429-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESNUT",
        "first_name": "CALEB",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004331B",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004331A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.