Organization Active NPI

Joseph L. Chatham, M.D. LTD

  • Specialist
  • Mesa, AZ
National Provider Identifier
1477691483
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15177 Issued in AZ
Legal business name
JOSEPH L. CHATHAM, M.D. LTD
Practice address
221 S Power Rd
Suite 101
Mesa, AZ 85206-5205
Phone
(480) 981-2010
Fax
(480) 981-1771
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Authorized official

Name
Dr. Joseph L Chatham, M.D.NPI 1417973496
Title
President
Phone
(480) 981-2010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 15177 AZ Primary

Addresses

Primary practice location

221 S Power Rd
Suite 101
Mesa, AZ 85206-5205

Mailing address

221 S Power Rd
Suite 101
Mesa, AZ 85206-5205
Phone (480) 981-2010

Other identifiers 1

IdentifierTypeStateIssuer
F02490MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000493 AZ Part B Supplier - Clinic/Group Practice 6305821570 Receives reassigned benefits from 2 practitioners
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1477691483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S POWER RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065205",
            "telephone_number": "480-981-2010",
            "fax_number": "480-981-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S POWER RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065205",
            "telephone_number": "480-981-2010",
            "fax_number": "480-981-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH L. CHATHAM, M.D. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "CHATHAM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-981-2010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "15177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F02490",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.