Active NPI
Courtney Emerson Chambers, M.D.
- Surgery Physician
- Fairfield, CA
National Provider Identifier
1528154523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G85771
- Practice address
- 1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533-3590 - Phone
- (707) 646-4180
- Fax
- (707) 646-4185
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G85771 | CA | Primary |
| Surgery Physician | 208600000X | 034618 | CT |
Addresses
Primary practice location
1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533-3590
Mailing address
1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533-3590
Phone (707) 646-4180
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20052765 | Other | CA | RAILROAD MEDICARE |
| 00G857710 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85771 | CA | MD | Marriage & Family Therapist |
| G85771 | CA | MD | Surgery Physician |
| 034618 | CT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nuvance Health Medical Practice CT, Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Danbury, CT
- NPI 1407898117
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357862400000",
"number": "1528154523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 PENNSYLVANIA AVE",
"address_2": "STE 200",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333590",
"telephone_number": "707-646-4180",
"fax_number": "707-646-4185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 PENNSYLVANIA AVE",
"address_2": "STE 200",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333590",
"telephone_number": "707-646-4180",
"fax_number": "707-646-4185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERS",
"first_name": "COURTNEY",
"middle_name": "EMERSON",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2013-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G85771",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "034618",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "20052765",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G857710",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.