Wahoo House Calls, LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

WAHOO HOUSE CALLS, LLC

Practice address

1615 Babbling Brook Dr
Grand Prairie, TX 75050-8317

Phone

(817) 808-5180

Fax

(972) 606-2820

NPI assigned

Dec 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Shawn L Chamberlain, PACNPI 1659444826

Title

Ceo

Phone

(817) 808-5180

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn L Chamberlain, PAC

  • Physician Assistant
  • Frisco, TX
  • NPI 1659444826
  NPD (past) Authorized official

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1447433784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 BABBLING BROOK DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750508317",
            "telephone_number": "817-808-5180",
            "fax_number": "972-606-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 BABBLING BROOK DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750508317",
            "telephone_number": "817-808-5180",
            "fax_number": "972-606-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAHOO HOUSE CALLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-808-5180",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Grand Prairie, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.