Individual provider Active NPI

Chetapon Nopachinda, DPM

  • Foot Surgery Podiatrist
  • Fayetteville, AR
National Provider Identifier
1538552948
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
2353 Issued in TX
Practice address
1100 N College Ave
Fayetteville, AR 72703-1944
Phone
(479) 443-4301
NPI assigned
Mar 9, 2015
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2353 TX
Foot Surgery Podiatrist 213ES0131X 2353 TX Primary

Addresses

Primary practice location

1100 N College Ave
Fayetteville, AR 72703-1944

Mailing address

1100 N College Ave
Fayetteville, AR 72703-1944
Phone (479) 443-4301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181023002598 TX Practitioner - Podiatry 8224301833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2353TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Fulshear Foot and Ankle PLLC Podiatrist CurrentSince Dec 14, 2022 Accepting new patients

Locations

7609 Tiki Dr
Ste D
Fulshear, TX 77441
Phone (281) 391-1212

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11544/brand/1/csg/1/fhir/r4

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

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1538552948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOPACHINDA",
        "first_name": "CHETAPON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "2353",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TX",
            "license": "2353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.