Individual provider Active NPI

Blake V Chamberlain, M.D.

  • Emergency Medicine Physician
  • Webster, TX
National Provider Identifier
1669457404
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J8218 Issued in TX
Practice address
500 Medical Center Blvd
Webster, TX 77598-4220
Phone
(281) 338-3110
Fax
(281) 338-3352
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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 J8218 TX Primary

Addresses

Primary practice location

500 Medical Center Blvd
Webster, TX 77598-4220

Mailing address

PO Box 200993
Houston, TX 77216-0993
Phone (281) 784-1111

Other identifiers 1

IdentifierTypeStateIssuer
8G7964OtherTXBCBSTX PROV NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040519001516 TX Practitioner - Emergency Medicine 7618968595 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J8218TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jones ER Physicians Staffing Inc Emergency Medicine CurrentSince May 7, 2020 Accepting new patients
Bay Area Emergency Partners Emergency Medicine CurrentSince Aug 29, 2010 Accepting new patients
Harbor Emergency Physicians PA Emergency Medicine CurrentSince May 7, 2020 Accepting new patients
Space City Emergency Physicians Emergency Medicine Past Accepting new patients
Greater Houston Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

17030 Northwest Fwy
Jersey Village, TX 77040
Phone (832) 232-0600

3725 E League City Pkwy
League City, TX 77573
Phone (281) 549-7032

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1669457404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200993",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772160993",
            "telephone_number": "281-784-1111",
            "fax_number": "281-784-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984220",
            "telephone_number": "281-338-3110",
            "fax_number": "281-338-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "BLAKE",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J8218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX PROV NO",
            "identifier": "8G7964",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.