Individual provider Active NPI

Nicholas Greer Chandler, PA-C

  • Physician Assistant
  • Brunswick, GA
National Provider Identifier
1427697002
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9915 Issued in GA
Practice address
2500 Starling St Ste 201
Brunswick, GA 31520-4267
Phone
(912) 265-5125
NPI assigned
Dec 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 9915 GA Primary

Addresses

Primary practice location

2500 Starling St Ste 201
Brunswick, GA 31520-4267

Mailing address

2500 Starling St Ste 201
Brunswick, GA 31520-4267
Phone (912) 265-5125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20201028001770 GA Practitioner - Physician Assistant 0547696742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

2500 Starling St
Suite 201
Brunswick, GA 31520-4267
Phone (912) 265-5125

Hospital & facility affiliations

  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Surgical Associates PastSince Nov 3, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nchand1@secure.sghsmessaging.org

Organizations & group practices 2

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.

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": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1427697002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST STE 201",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204267",
            "telephone_number": "912-265-5125",
            "fax_number": "912-261-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST STE 201",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204267",
            "telephone_number": "912-265-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "NICHOLAS",
        "middle_name": "GREER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-31",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.