Brian Keith Chamberlain, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102572 Issued in FL

Practice address

455 Pinellas St
#320
Clearwater, FL 33756-3354

Phone

(727) 446-2273

Fax

(727) 441-4966

NPI assigned

Feb 17, 2006

Last updated

Apr 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Baycare Medical Group Pediatric Walk-in Care LLC

  • Pediatrics Physician
  • Lutz, FL
  • NPI 1861850117
  NPD (past)
• Baycare Medical Group Pediatric Walk-in, LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1679724488
  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1568437119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743409",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743409",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PINELLAS ST",
            "address_2": "#320",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563354",
            "telephone_number": "727-446-2273",
            "fax_number": "727-441-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291808100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "225992",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Cha
• Rosemary Chacko, PHARMD
• Tanya Janine Chadwick, LCSW
• Chamberlain Dental (Theodore K Chamberlain DMD PA)
• Alex Chamberlain
• Theodore Kerry Chamberlain, D.M.D
• Gabrielle Hope Chamberlin, PA-C
• Melissa Vesilki Chambers, LMHC
• Champagne Dental Corp
• Raymond Nam Shan Chan, M.D.

• Physician Assistant in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.