Individual provider Active NPI

William E Chandler, MD

  • Emergency Medicine Physician
  • Albany, GA
National Provider Identifier
1669468179
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
043611 Issued in GA
Practice address
417 W 3Rd Ave
Albany, GA 31701-1943
Phone
(229) 312-4155
Fax
(229) 312-4176
NPI assigned
Sep 21, 2005
Last updated
Nov 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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 043611 GA Primary

Addresses

Primary practice location

417 W 3Rd Ave
Albany, GA 31701-1943

Mailing address

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-4155

Other identifiers 6

IdentifierTypeStateIssuer
000774419FMedicaidGA
364834OtherGAWELLCARE
P00049284OtherGARAILROAD MEDICARE
000774419HMedicaidGA
52027351001OtherGABCBS
52027351-003OtherGABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040618000882 GA Practitioner - Emergency Medicine 3870578545 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Emergency Associates, LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Phoebe Worth Medical Center, Inc CurrentSince Feb 1, 2014 Accepting new patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Mar 18, 2014 Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Mar 1, 2014 Accepting new patients
Phoebe Worth Medical Center, Inc CurrentSince Feb 1, 2014 Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Mar 1, 2014 Accepting new patients

Locations

2000 Palmyra Rd
Albany, GA 31701
Phone (229) 434-2000

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1014 W Franklin St
Sylvester, GA 31791
Phone (229) 776-2965

807 S Isabella St
Sylvester, GA 31791
Phone (229) 777-3851

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1669468179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-4155",
            "fax_number": "229-312-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-4155",
            "fax_number": "229-312-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "043611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000774419F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "364834",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00049284",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000774419H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52027351001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52027351-003",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.