NPIMap

Individual provider Active NPI

Jeaneen Chappell, M.D.

  • Dermatology Physician
  • Grand Prairie, TX
National Provider Identifier
1497915623
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
Q6501 Issued in TX
Practice address
4927 Lake Ridge Pkwy
Grand Prairie, TX 75052-3087
Phone
(817) 466-8651
NPI assigned
Jun 11, 2008
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01089686A IN
Dermatology Physician 207N00000X Q6501 TX Primary

Addresses

Primary practice location

4927 Lake Ridge Pkwy
Grand Prairie, TX 75052-3087

Mailing address

4927 Lake Ridge Pkwy
Grand Prairie, TX 75052-3087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AL, SD, WI4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20160125000576 TX Practitioner - Dermatology 4183843584 Reassigns benefits to 1 organization
I20231006002107 AL Practitioner - Dermatology 4183843584
I20260115004129 SD Practitioner - Dermatology 4183843584 Reassigns benefits to 1 organization
I20260409001090 WI Practitioner - Dermatology 4183843584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
87.71
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions181
Removal or shaving of skin growth1-10
Skin biopsy16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01089686AINMDDermatology Physician
Q6501TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc. CurrentSince Dec 2, 2025 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Dec 2, 2025 Accepting new patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Dec 1, 2021 Accepting new patients
Dermatology Associates Dermatology PastSince Dec 1, 2021 Accepting new patients
Pediatric Dermatology of No. TX Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

6117 Berkshire Ln
Dallas, TX 75225
Phone (214) 373-3376

8210 Walnut Hill Ln
Ste 810
Dallas, TX 75231
Phone (214) 363-1885

5030 Tennyson Pkwy
Ste 100
Plano, TX 75024
Phone (972) 945-3854

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1497915623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4927 LAKE RIDGE PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 LAKE RIDGE PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523087",
            "telephone_number": "817-466-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELL",
        "first_name": "JEANEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01089686A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q6501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.