Chennell Family Wellness, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-36397 Issued in KS

Legal business name

CHENNELL FAMILY WELLNESS, LLC

Practice address

1101 N Main St
McPherson, KS 67460-2845

Phone

(620) 504-5996

Fax

(888) 263-5552

NPI assigned

Jul 31, 2018

Organization subpart

No

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

Authorized official

Name

Alicia Chennell, MDNPI 1639465982

Title

Owner

Phone

(620) 480-9597

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia R Chennell, MD

  • Family Medicine Physician
  • McPherson, KS
  • NPI 1639465982
  Medicare reassignment Care Compare group NPD Authorized official
• Samantha M Graber, MD

  • Family Medicine Physician
  • McPherson, KS
  • NPI 1184281644
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1538647755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N MAIN ST",
            "city": "MCPHERSON",
            "state": "KS",
            "postal_code": "674602845",
            "telephone_number": "620-504-5996",
            "fax_number": "888-263-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N MAIN ST",
            "city": "MCPHERSON",
            "state": "KS",
            "postal_code": "674602845",
            "telephone_number": "620-504-5996",
            "fax_number": "888-263-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENNELL FAMILY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "CHENNELL",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-480-9597",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-36397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "04-36397",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201207900A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather R Case, AT, PTA
• Micaela C Case
• Jon D. Casimir, MD
• Cedars, Inc.
• Central Christian College of Kansas
• Alicia R Chennell, MD
• Chris Goodson Appraisal Services
• CK Pharmacies LLC
• CK Pharmacies LLC
• Barbara Claassen, LMSW

• Family Medicine Physician in McPherson, KS
• Providers in McPherson, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.