Active NPI
Benjamin Chacko, MD
- Military Health Care Provider
- Goose Creek, SC
National Provider Identifier
1619729670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 0101287091
- Practice address
- 110 Nnptc Cir
Goose Creek, SC 29445-6314 - Phone
- (843) 794-6000
- NPI assigned
- Apr 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 0101287091 | VA | Primary |
Addresses
Primary practice location
110 Nnptc Cir
Goose Creek, SC 29445-6314
Mailing address
110 Nnptc Cir
Goose Creek, SC 29445-6314
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101287091 | VA | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764892800000",
"number": "1619729670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 NNPTC CIR",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294456314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 NNPTC CIR",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294456314",
"telephone_number": "843-794-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACKO",
"first_name": "BENJAMIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-03",
"last_updated": "2025-12-05",
"certification_date": "2025-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "VA",
"license": "0101287091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.