Individual provider Active NPI

Chaundra J Maddox, MD

  • Pediatrics Physician
  • Huntington, WV
National Provider Identifier
1699739904
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
19854 Issued in WV
Practice address
1600 Medical Center Dr
Suite 3500
Huntington, WV 25701-3656
Phone
(304) 691-1300
Fax
(304) 691-1375
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 19854 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr
Suite 3500
Huntington, WV 25701-3656

Mailing address

1600 Medical Center Dr
Suite 3500
Huntington, WV 25701-3656
Phone (304) 691-1300

Other identifiers 3

IdentifierTypeStateIssuer
2149642MedicaidOH
64000003MedicaidKY
6700369000MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chaundra.maddox@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20110314000209 WV Practitioner - Geriatric MedicinePractitioner - Pediatric Medicine 8527240449 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Jan 21, 2011 Accepting new patients
University Physicians & Surgeons, Inc Pediatrics CurrentSince Jan 21, 2011 Accepting new patients

Locations

1249 15th St
#4093
Huntington, WV 25701

3075 US Route 60
#D
Huntington, WV 25705
Phone (304) 399-4422

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

Interoperability endpoints

  • Direct secure messaging: chaundra.maddox@marshall.cernerdirect.com

Organizations & group practices 2

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1699739904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "CHAUNDRA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "19854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2149642",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64000003",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6700369000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chaundra.maddox@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite 3500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.