NPIMap

Individual provider Active NPI

Gerald Guy Lachance, DO

  • Family Medicine Physician
  • Chipley, FL
National Provider Identifier
1437111473
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1707 Issued in ME
Practice address
1360 Brickyard Rd
Chipley, FL 32428-6303
Phone
(850) 415-8303
Fax
(207) 795-8490
NPI assigned
Apr 5, 2006
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1707 ME Primary

Addresses

Primary practice location

1360 Brickyard Rd
Chipley, FL 32428-6303

Mailing address

1360 Brickyard Rd
Chipley, FL 32428-6303
Phone (850) 415-8303

Other identifiers 1

IdentifierTypeStateIssuer
113382300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060213000093 FL Practitioner - General Practice 4587679535 Reassigns benefits to 2 organizations
I20130808000855 ME Practitioner - Family Practice 4587679535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1360 Brickyard Rd
Chipley, FL 32428-6303
Phone (850) 638-1610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1707MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Jul 1, 2013 Accepting new patients
Northwest Florida Healthcare, Inc CurrentSince Nov 1, 2021 Accepting new patients
Northwest Florida Healthcare, Inc CurrentSince Nov 1, 2021 Accepting new patients
Central Maine Medical Center CurrentSince Jul 1, 2013 Accepting new patients
Northwest Florida Primary Care LLC Past Accepting new patients
Primecare of NW FL Family Medicine Past Accepting new patients
Northwest Florida Healthcare, Inc Family Medicine Past Accepting new patients

Locations

1360 Brickyard Rd
Chipley, FL 32428
Phone (850) 415-8300

925 Carlisle Rd
Chipley, FL 32428
Phone (850) 526-3236

789 Minot Ave
Auburn, ME 04210
Phone (207) 795-8475

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

364 Main St
Lewiston, ME 04240
Phone (207) 795-5646

Interoperability endpoints

  • Direct secure messaging: gerald.lachance.1@14612.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 7

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 6

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1437111473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BRICKYARD RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286303",
            "telephone_number": "850-415-8303",
            "fax_number": "207-795-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BRICKYARD RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286303",
            "telephone_number": "850-415-8303",
            "fax_number": "207-795-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHANCE",
        "first_name": "GERALD",
        "middle_name": "GUY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113382300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chipley, FL

Sources for this page

Verify at the official NPI Registry.