Douglas Eric Chamberlin, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

034399 Issued in CT

Practice address

49 Welles St
Suite 202
Glastonbury, CT 06033-4205

Phone

(860) 659-4010

Fax

(860) 659-3783

NPI assigned

Jan 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 27, 2016 through Jan 27, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Fox Run Psychiatric Associates PC

  • Psychiatry Physician
  • Glastonbury, CT
  • NPI 1548931389
  NPD Authorized official
• The Center for Geriatric and Family Psychiatry, Inc.

  • Mental Health Counselor
  • Glastonbury, CT
  • NPI 1831134766
  NPD (past)

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1710044847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 WELLES ST",
            "address_2": "SUITE 202",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334205",
            "telephone_number": "860-659-4010",
            "fax_number": "860-659-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 WELLES ST",
            "address_2": "SUITE 202",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334205",
            "telephone_number": "860-659-4010",
            "fax_number": "860-659-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLIN",
        "first_name": "DOUGLAS",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "034399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Connecticut Orofacial Sleep Medicine Inc
• Brianna Rose Cervizzi, DPT
• Susanne Cesana, HEALTH COACH
• Jenny Y Cha, O.D.
• Meghan Chafee, MSN, APRN, FNP-C
• Clifford Chambers Jr., CPT, CET, CCHT
• Randy Louis Champagne, COTA/L
• Clarissa Chan, PHARMD
• Courtney Chan, LCSW
• Changepoint, LLC

• Psychiatry Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.