Individual provider Active NPI

Rachel Chacon

  • Adult Health Nurse Practitioner
  • Sheppard AFB, TX
National Provider Identifier
1407423825
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1036832 Issued in TX
Practice address
527 Tuskegee Airmen Ave. BLDG 500
Sheppard AFB, TX 76311-6549
Phone
(940) 676-1232
NPI assigned
Jun 4, 2021
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1036832 TX Primary

Addresses

Primary practice location

527 Tuskegee Airmen Ave. BLDG 500
Sheppard AFB, TX 76311-6549

Mailing address

527 Tuskegee Airmen Ave. BLDG 500
Sheppard AFB, TX 76311-6549
Phone (940) 676-1232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211203001774 TX Practitioner - Nurse Practitioner 7012307119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1036832TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fahad Omar MD PA CurrentSince Jul 1, 2024 Accepting new patients
Infinite Medical PC CurrentSince Sep 16, 2022 Accepting new patients
Revive Global PLLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

1512 N Zaragoza Rd
Ste B
El Paso, TX 79936
Phone (915) 249-3900

5539 N Mesa St
El Paso, TX 79912

1201 Colonel Dr
Garland, TX 75043
Phone (210) 602-1140

15015 Cypress Wood Medical Dr
Houston, TX 77014
Phone (281) 301-1149

411 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 885-7668

424 Tarpey Rd
Texas City, TX 77591
Phone (409) 938-8431

8001 Western Hills Blvd
Wht Settlemt, TX 76108
Phone (817) 246-4953

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1407423825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 TUSKEGEE AIRMEN AVE. BLDG 500",
            "city": "SHEPPARD AFB",
            "state": "TX",
            "postal_code": "763116549",
            "telephone_number": "940-676-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 TUSKEGEE AIRMEN AVE. BLDG 500",
            "city": "SHEPPARD AFB",
            "state": "TX",
            "postal_code": "763116549",
            "telephone_number": "940-676-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1036832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheppard AFB, TX

Sources for this page

Verify at the official NPI Registry.