Organization Active NPI

Chaffee Family Care LLC

  • Family Nurse Practitioner
  • Chaffee, MO
National Provider Identifier
1669946869
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CHAFFEE FAMILY CARE LLC
Practice address
206 S Main St
Chaffee, MO 63740-1002
Phone
(573) 475-7071
Fax
(573) 475-7237
NPI assigned
Jan 22, 2019
Last updated
Sep 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
Misty Wilhite, NPNPI 1750897096
Title
Owner
Phone
(573) 475-7071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

206 S Main St
Chaffee, MO 63740-1002

Mailing address

206 S Main St
Chaffee, MO 63740-1002
Phone (573) 475-7071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190207001544 MO Part B Supplier - Clinic/Group Practice 4981942471 Receives reassigned benefits from 1 practitioner
Practice locations: Patton, MO; Cape Girardeau, MO; Marble Hill, MO; Fredericktown, MO; Chaffee, MO; 1205 S Mount Auburn Rd, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2279112Chaffee Family Care, LLC206 South Main St, Chaffee, MO 63740Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory

Locations

320 N Chamber Dr
Fredericktown, MO 63645
Phone (537) 783-4511

9651 State Highway 72
Patton, MO 63662
Phone (573) 866-2003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1669946869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST",
            "city": "CHAFFEE",
            "state": "MO",
            "postal_code": "637401002",
            "telephone_number": "573-475-7071",
            "fax_number": "573-475-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST",
            "city": "CHAFFEE",
            "state": "MO",
            "postal_code": "637401002",
            "telephone_number": "573-475-7071",
            "fax_number": "573-475-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAFFEE FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "WILHITE",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-475-7071",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaffee, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.