Kenyon Mala Chavis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200801349 Issued in NC

Practice address

901 Denim Dr
Erwin, NC 28339-2307

Phone

(910) 897-5521

Fax

(910) 897-2003

NPI assigned

Aug 26, 2008

Last updated

Aug 3, 2021By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of North Carolina at Chapel Hill School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

House Calls of the District of Columbia IncGroup PAC ID 5991092900, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenyon.chavis.1@23141.direct.athenahealth.com

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.

• House Calls of the District of Columbia Inc

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1609329465
  Medicare reassignment Care Compare group
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1578710141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 DENIM DR",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283392307",
            "telephone_number": "910-897-5521",
            "fax_number": "910-897-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DENIM DR",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283392307",
            "telephone_number": "910-897-5521",
            "fax_number": "910-897-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "KENYON",
        "middle_name": "MALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200801349",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2008-01349",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910124",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cape Fear Valley Health Medical Group LLC (Cape Fear Valley Internal Medicine Continuity Clinic-Erwin)
• Cape Fear Valley Health Medical Group LLC (Cape Fear Valley Primary Care-Erwin)
• Carenet, Inc. (Baptist Hospital Carenet Counseling Centers)
• Carolina Sleep and Respiratory, LLC
• Elizabeth Kristin Charney, DPT
• Molly Cisler
• Jennifer Brooke Collins, PHARMD
• Community Health &Wellness Inc
• Ryan Costner, DDS
• Lisa Morrison Cox

• Family Medicine Physician in Erwin, NC
• Providers in Erwin, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.