Individual provider Active NPI

Ann S Chinnis, M.D.

  • Emergency Medicine Physician
  • Morgantown, WV
National Provider Identifier
1619070547
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
16533 Issued in WV
Practice address
101 Stadium Drive
Morgantown, WV 26506
Phone
(304) 598-4000
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 16533 WV Primary

Addresses

Primary practice location

101 Stadium Drive
Morgantown, WV 26506

Mailing address

P. O. Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
0043626000MedicaidWV

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

LicenseStateTypeSpecialty
16533WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Emergency Medical Care, LTD. Emergency Medicine Past Accepting new patients
Tidewater Emergency Medical Care PastSince Feb 2, 2020 Accepting new patients
Riverside Physician Services, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1619070547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 897",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070897",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINNIS",
        "first_name": "ANN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "16533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043626000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.