Individual provider Active NPI

Kathleen Marie Chauvin, MD

  • Family Medicine Physician
  • Wolfeboro, NH
National Provider Identifier
1669405395
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301055222 Issued in MI
Practice address
240 S Main St
Wolfeboro, NH 03894-4411
Phone
(603) 569-7500
NPI assigned
Jul 8, 2006
Last updated
Nov 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 4301055222 MI
Family Medicine Physician 207Q00000X 4301055222 MI Primary

Addresses

Primary practice location

240 S Main St
Wolfeboro, NH 03894-4411

Mailing address

2845 Capital Ave SW
Ste 301
Battle Creek, MI 49015-4188
Phone (269) 969-6183

Other identifiers 1

IdentifierTypeStateIssuer
2934571MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141217001784 NM Practitioner - Family Practice 0446307318 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Dec 1, 2014 Accepting new patients
Presbyterian Healthcare Services CurrentSince Dec 1, 2014 Accepting new patients
Lovelace Health System LLC Family Medicine PastSince Feb 27, 2018 Accepting new patients

Locations

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

301 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-7000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1669405395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 CAPITAL AVE SW",
            "address_2": "STE 301",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154188",
            "telephone_number": "269-969-6183",
            "fax_number": "269-969-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S MAIN ST",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "038944411",
            "telephone_number": "603-569-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUVIN",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MI",
            "license": "4301055222",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301055222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2934571",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolfeboro, NH

Sources for this page

Verify at the official NPI Registry.