Active NPI
Celso R Chavez, MD
- Family Medicine Physician
- Lewiston, ID
National Provider Identifier
1386795565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M5480
- Practice address
- 1522 17TH St
Lewiston, ID 83501-3652 - Phone
- (208) 743-8416
- Fax
- (208) 743-4642
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M5480 | ID | Primary |
Addresses
Primary practice location
1522 17TH St
Lewiston, ID 83501-3652
Mailing address
1522 17TH St
Lewiston, ID 83501-3652
Phone (208) 743-8416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5480 | ID | MD | Family Medicine Physician |
Interoperability endpoints
- celso.chavez@tsmh.medicity.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386795565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1522 17TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835013652",
"telephone_number": "208-743-8416",
"fax_number": "208-743-4642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1522 17TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835013652",
"telephone_number": "208-743-8416",
"fax_number": "208-743-4642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "CELSO",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M5480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.