Organization Active NPI

Crandall M. Chambers, M.D., LLC

  • Obstetrics Physician
  • Columbus, GA
National Provider Identifier
1396953790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
043182 Issued in GA
Legal business name
CRANDALL M. CHAMBERS, M.D., LLC
Practice address
811 22ND St
Columbus, GA 31904-8822
Phone
(706) 323-1054
Fax
(706) 327-6270
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Crandall Menton Chambers, M.D.NPI 1831238427
Title
Physician Owner
Phone
(706) 323-1054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X 043182 GA Primary

Addresses

Primary practice location

811 22ND St
Columbus, GA 31904-8822

Mailing address

811 22ND St
Columbus, GA 31904-8822
Phone (706) 323-1054

Other identifiers 1

IdentifierTypeStateIssuer
0099336633MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120203000263 GA Part B Supplier - Clinic/Group Practice 5193982049 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, GA

National Provider Directory

National Provider Directory

Locations

5009 Riverchase Dr
Ste A
Phenix City, AL 36867
Phone (334) 214-9766

811 22nd St
Columbus, GA 31904
Phone (706) 323-1054

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396953790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 22ND ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048822",
            "telephone_number": "706-323-1054",
            "fax_number": "706-327-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 22ND ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048822",
            "telephone_number": "706-323-1054",
            "fax_number": "706-327-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANDALL M. CHAMBERS, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "CRANDALL",
        "authorized_official_middle_name": "MENTON",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "706-323-1054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "043182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099336633",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.