Chenelle D McCaskill, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA1103 Issued in OR

Practice address

2570 NW Edenbower Blvd
Ste 100
Roseburg, OR 97471

Phone

(541) 957-1111

Fax

(541) 229-3335

NPI assigned

Jun 23, 2005

Last updated

Jun 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1134436637
  Medicare reassignment
• Centennial Medical Group East, LLC

  • Obstetrics & Gynecology Physician
  • Roseburg, OR
  • NPI 1134243249
  NPD
• Centennial Medical Group East, LLC

  dba Evergreen Family Medicine North

  • Family Medicine Physician
  • Sutherlin, OR
  • NPI 1164124111
  NPD
• C L Soo MD PC

  • Orthopaedic Surgery of the Spine Physician
  • Oklahoma City, OK
  • NPI 1588983100
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1497751515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 NW EDENBOWER BLVD",
            "address_2": "STE 100",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-957-1111",
            "fax_number": "541-229-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 NW EDENBOWER BLVD",
            "address_2": "STE 100",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-957-1111",
            "fax_number": "541-229-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCASKILL",
        "first_name": "CHENELLE",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA01103",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA1103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley McBride
• Emily McCaffery
• John McCaffrey, M.D.
• Deidre Ann McCann, MD
• Caroline A McCants, N.P.
• Mandilynn Kay McClain, M.S.
• Heather McClinton
• James Shawn McCowin, L.M.P.
• Ashley McCraw
• Bryan McCrea, LPC

• Surgical Physician Assistant in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.