Katherine Ann Chamberlain, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301054438 Issued in MI

Practice address

1555 Industrial Dr
Owosso, MI 48867-9775

Phone

(989) 723-6791

Fax

(989) 725-5061

NPI assigned

Sep 20, 2005

Sex

Female

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 3

Other names 1

• Katherine Ann Pomaville Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Bay-Arenac Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bay City, MI
  • NPI 1154439438
  Medicare reassignment NPD
• Shiawassee County Community Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Owosso, MI
  • NPI 1497749279
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1497741052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "48867",
            "telephone_number": "989-723-6791",
            "fax_number": "989-725-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 INDUSTRIAL DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679775",
            "telephone_number": "989-723-6791",
            "fax_number": "989-725-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301054438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0G86005",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "2607800342",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "KC054438",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "POMAVILLE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Delaney Cauthen
• Central Pharmacy-Owosso LLC
• Central Pharmacy-Owosso LLC
• Clay Chadwell
• Iman Chamas, PA-C
• Sam Chan, DC
• Richard L Chapin, DPM
• Charles G. Norman II DDS PC
• Samantha Chartier
• Jenna Rae Chartrand, MSOT, OTR/L

• Psychiatry Physician in Owosso, MI
• Providers in Owosso, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.