Individual provider Active NPI

William Rataphon Chamnin, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1376664524
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00845 Issued in NC
Practice address
1912 Tradd CT
Wilmington, NC 28401-6637
Phone
(910) 251-3766
Fax
(910) 251-3760
NPI assigned
Apr 3, 2007
Last updated
May 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00845 NC Primary

Addresses

Primary practice location

1912 Tradd CT
Wilmington, NC 28401-6637

Mailing address

PO Box 936857
Atlanta, GA 31193-6857

Other identifiers 1

IdentifierTypeStateIssuer
0010-00845OtherNCMEDICAL BOARD

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070705000271 NC Practitioner - Physician Assistant 9931209962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1912 Tradd CT
Wilmington, NC 28401-6637
Phone (910) 251-3766

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-5105

231 S 17TH St
Wilmington, NE 28401-7407
Phone (910) 667-5105

800 Jefferson St
Suite 112
Whiteville, NC 28472-3702
Phone (910) 662-9500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-00845NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Feb 1, 2021 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince May 1, 2021 Accepting new patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1415 Physicians Dr
Wilmington, NC 28401
Phone (910) 251-3766

1912 Tradd Ct
Wilmington, NC 28401
Phone (910) 251-3766

Interoperability endpoints

  • Direct secure messaging: wchamnin1244440@direct.novanthealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1376664524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 TRADD CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016637",
            "telephone_number": "910-251-3766",
            "fax_number": "910-251-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMNIN",
        "first_name": "WILLIAM",
        "middle_name": "RATAPHON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "0010-00845",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.