Jeaneen Chappell, M.D.
Individual provider Active NPI Dermatology Physician · Grand Prairie, TX
NPI 1497915623 · NPPES record last updated Jul 6, 2023
Key facts
- NPI
- 1497915623
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- Q6501 (TX)
- Practice address
- 4927 Lake Ridge Pkwy
Grand Prairie, TX 75052-3087 - Phone
- (817) 466-8651
- NPI assigned
- Jun 11, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 13
Medicare Care Compare profile
- 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
- Monument Health Rapid City Hospital Inc
Practice addresses (Care Compare)
353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109
Hospital & facility affiliations
- Tamarack Health Ashland Medical Center
- Monument Health Rapid City Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.86 of 100
- Quality
- 87.71
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 181 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 16 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in TX, AL, SD, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01089686A | IN | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oliver Street 5.01(a) Inc. | Dermatology | Current |
Accepting new patients |
| Monument Health Rapid City Hospital, Inc. | Current |
Accepting new patients | |
| Monument Health Rapid City Hospital Inc | Current |
Accepting new patients | |
| Pediatric Dermatology of No. TX | Past | Accepting new patients | |
| Dermatology Associates | Dermatology | Past |
Accepting new patients |
Locations
353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000
6117 Berkshire Ln
Dallas, TX 75225
Phone (214) 373-3376
5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672
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
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 01089686A | IN | |
| Dermatology Physician | 207N00000X | Q6501 | TX | Yes |
Addresses
Primary practice location
4927 Lake Ridge Pkwy
Grand Prairie, TX 75052-3087
Mailing address
4927 Lake Ridge Pkwy
Grand Prairie, TX 75052-3087
Other providers in Grand Prairie, TX
- Cody Don Champagne
- Champions for Life Inc
- Breanna Chance
- Thanuja D Chandrasena
- Roderick Adrian Chapman Jr.
- Jayshri Chasmawala
- Chaitanya B Chavda
- Eugene Chen
- Yi-Ju Chen
- Shawn Cherian
All providers in Grand Prairie, TX · Dermatology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.