Active NPI
Jeffrey Beecham Chick, M.D.
- Gynecology Physician
- Wilmington, NC
National Provider Identifier
1477650554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 127721
- Practice address
- 1201 Porches Dr
Suite 2
Wilmington, NC 28409 - Phone
- (315) 727-6084
- Fax
- (315) 579-2561
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 127721-1 | NY | |
| Gynecology Physician | 207VG0400X | 127721 | NY | Primary |
Addresses
Primary practice location
1201 Porches Dr
Suite 2
Wilmington, NC 28409
Mailing address
Jeffrey B. Chick M.D.
1201 Porches Dr
Wilmington, NC 28409
Phone (315) 579-2560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00570434 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127721-1 | NY | MD | Specialist |
| 127721 | NY | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547164800000",
"number": "1477650554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "JEFFREY B. CHICK M.D.",
"address_2": "1201 PORCHES DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "28409",
"telephone_number": "315-579-2560",
"fax_number": "315-579-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 PORCHES DR",
"address_2": "SUITE 2",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "28409",
"telephone_number": "315-727-6084",
"fax_number": "315-579-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHICK",
"first_name": "JEFFREY",
"middle_name": "BEECHAM",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2019-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "127721-1",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NY",
"license": "127721",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00570434",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.