Misty R Chambers, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1501369 Issued in KS

Practice address

4930 Overland Dr
Lawrence, KS 66049-4132

Phone

(785) 856-0708

Fax

(785) 856-0709

NPI assigned

Feb 22, 2010

Sex

Female

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 1

Other names 1

• Misty R Koch Former name

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Olathe Health Physicians, Inc.

  • Family Medicine Physician
  • Olathe, KS
  • NPI 1598784639

  KS

  Medicare reassignment
• Uk St Francis Urgent Care

  • Urgent Care Clinic/Center
  • Topeka, KS
  • NPI 1457970782

  KS

  Medicare reassignment
• Carbon Health Medical Group of Kansas PA

  • Urgent Care Clinic/Center
  • Kansas City, MO
  • NPI 1497357396

  KS

  Medicare reassignment
• Olathe Health Physicians, Inc.

  • Psychiatry Physician
  • Olathe, KS
  • NPI 1326548710
  NPD
• Olathe Health Physicians, Inc.

  • Family Medicine Physician
  • Gardner, KS
  • NPI 1558879320
  NPD
• Advanced Medical Imaging, LLC

  • Diagnostic Radiology Physician
  • Lawrence, KS
  • NPI 1215400775
  NPD (past)
• Family Centered Medicine

  • Primary Care Clinic/Center
  • Lawrence, KS
  • NPI 1013314822
  NPD (past)

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1629390331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 OVERLAND DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494132",
            "telephone_number": "785-856-0708",
            "fax_number": "785-856-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 OVERLAND DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494132",
            "telephone_number": "785-856-0708",
            "fax_number": "785-856-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "MISTY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-22",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1501369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200686550A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "KOCH",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Alexandra Chacon, CCC-SLP
• Sheila Chaffee
• Katrina T Chagollan
• Nicholas Chamberlain, DDS
• Breah Chambers, APRN
• Elizabeth Chan
• Piper Chaney
• Chang Chiropractic and Acupuncture Clinic, P.a.
• Elizabeth W Chao, LSCSW
• Ann Chapman, R.D.

• All providers in Lawrence, KS
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.