Individual provider Active NPI

Wayne L Chappelle Sr., PSY.D.

  • Clinical Psychologist
  • Wright Patterson Afb, OH
National Provider Identifier
1720056690
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2874 Issued in NC
Practice address
2510 Fifth Street, Usafsam, BLDG 840
Wright Patterson Afb, OH 45433
Phone
(937) 938-2706
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2874 NC Primary

Addresses

Primary practice location

2510 Fifth Street, Usafsam, BLDG 840
Wright Patterson Afb, OH 45433

Mailing address

2510 Fifth Street BLDG 840 Area B
Wright Patterson Afb, OH 45433
Phone (937) 938-2706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721003881 OH Practitioner - Clinical Psychologist 9032590021 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Post-Acute Medical Services 1 IncGroup PAC ID 5991081911, 7 clinicians
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians

Practice addresses (Care Compare)

1001 E Alex Bell Rd
Dayton, OH 45459-2637
Phone (937) 436-9700

2270 Park Hills Dr
Fairborn, OH 45324-3993
Phone (855) 245-9112

425 Lauricella CT
Englewood, OH 45322-0340
Phone (937) 836-5143

6800 Paragon Rd
Dayton, OH 45459-3166
Phone (937) 438-0054

7300 McEwen Rd
Dayton, OH 45459-3903
Phone (937) 433-3444

7383 Paragon Rd
Dayton, OH 45459-4119
Phone (937) 999-2586

7800 Dayton Springfield Rd
Fairborn, OH 45324-1997
Phone (937) 203-8449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2874NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Post-Acute Medical Services 1 Inc CurrentSince Jul 1, 2022 Accepting new patients
NV Pacs 2 LLC CurrentSince Jul 1, 2022 Accepting new patients
CS Pacs 3 Midwest LLC CurrentSince Aug 1, 2024 Accepting new patients
Mi Pacs 2 PC Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

425 Lauricella Ct
Englewood, OH 45322
Phone (937) 836-5143

Organizations & group practices 4

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1720056690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 FIFTH STREET BLDG 840 AREA B",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-938-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 FIFTH STREET, USAFSAM, BLDG 840",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-938-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELLE",
        "first_name": "WAYNE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

Verify at the official NPI Registry.