John Gerald Chiles, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME127268 Issued in FL

Practice address

1005 Mar Walt Drive
Pediatrics
Fort Walton Beach, FL 32547-6796

Phone

(850) 863-8203

Fax

(850) 863-8113

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1407191216
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1487620845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476796",
            "telephone_number": "850-863-8203",
            "fax_number": "850-863-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "PEDIATRICS",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476796",
            "telephone_number": "850-863-8203",
            "fax_number": "850-863-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILES",
        "first_name": "JOHN",
        "middle_name": "GERALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME127268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019796900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "HSZVI",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leo C Chen, M.D.
• Jody Edwards Chesser, AUD
• Kayla Marie Chevannes, B.S.
• Chelsi Chilcott
• Children'S Home Society of Florida
• Amanda Chika Chima
• Patricia S Christie, ARNP
• Melissa Chrites
• Michelle L Chumbley, RBT
• Caitlin Bria Chumley, PTA

• Pediatrics Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.