Individual provider Active NPI

Roger Bryan Chapman, FNP-C

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1750805941
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP134675 Issued in TX
Practice address
6115 New Copeland Rd
Tyler, TX 75703
Phone
(833) 724-6725
Fax
(903) 405-1524
NPI assigned
Jul 28, 2017
Last updated
Jun 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP134675 TX Primary

Addresses

Primary practice location

6115 New Copeland Rd
Tyler, TX 75703

Mailing address

1809 Balsam Gap
Tyler, TX 75703-7325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016002341 TX Practitioner - Nurse Practitioner 2466727516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charles R Gordon MD PAGroup PAC ID 8729992052, 24 clinicians
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

2737 S Broadway Ave
Tyler, TX 75701-5413
Phone (903) 592-6000

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pallicare, Inc Nurse Practitioner CurrentSince Dec 2, 2021 Accepting new patients
Charles R Gordon MD PA CurrentSince Jan 16, 2019 Accepting new patients
Charles R Gordon MD PA Nurse Practitioner CurrentSince Jan 16, 2019 Accepting new patients

Locations

116 Christie Dr
Lufkin, TX 75904
Phone (903) 592-6000

3900 NE Stallings Dr
Ste 101
Nacogdoches, TX 75965
Phone (936) 249-1866

Interoperability endpoints

  • Direct secure messaging: roger.chapman.p1@direct.precisionspinecare.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1750805941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 BALSAM GAP",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "833-724-6725",
            "fax_number": "903-405-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "ROGER",
        "middle_name": "BRYAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-28",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP134675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.