Individual provider Active NPI

Rebecca Joy Chibnall, MD

  • Dermatology Physician
  • Saint Louis, MO
National Provider Identifier
1689935728
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2013023315 Issued in MO
Practice address
5225 Mid America PLZ Ste 2300
Ste 2300
Saint Louis, MO 63129-0002
Phone
(314) 942-6386
Fax
(314) 289-1908
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2013023315 MO Primary

Addresses

Primary practice location

5225 Mid America PLZ Ste 2300
Ste 2300
Saint Louis, MO 63129-0002

Mailing address

660 S Euclid Ave
C B 8123
Saint Louis, MO 63110-1010
Phone (314) 942-6386

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160629000459 MO Practitioner - DermatologyPractitioner - Internal Medicine 8123319779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meramec Dermatology LLCGroup PAC ID 4082941604, 12 clinicians

Practice addresses (Care Compare)

3783 Vogel Rd
Arnold, MO 63010-6202
Phone (636) 751-0995

Merit-based Incentive Payment System (MIPS)

Final score
94.88 of 100Reported as group
Quality
89.76
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions456
Removal or shaving of skin growth1-10
Skin biopsy167

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meramec Dermatology LLC Dermatology CurrentSince Jun 15, 2020 Accepting new patients
Ozarks Medical Center Dermatology Past Accepting new patients

Locations

3783 Vogel Rd
Arnold, MO 63010
Phone (636) 751-0995

1204 E State Route 72
Rolla, MO 65401
Phone (573) 364-1934

3555 Sunset Office Dr
Ste C102
Saint Louis, MO 63127
Phone (314) 858-1858

4800 Mexico Rd
Ste 104
Saint Peters, MO 63376
Phone (636) 916-4625

Organizations & group practices 3

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1689935728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8123",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-942-6386",
            "fax_number": "314-286-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 MID AMERICA PLZ STE 2300",
            "address_2": "STE 2300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290002",
            "telephone_number": "314-942-6386",
            "fax_number": "314-289-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIBNALL",
        "first_name": "REBECCA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2013023315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.