NPIMap

Individual provider Active NPI

Chaseton Nielsen, DO

  • Family Medicine Physician
  • Sanford, NC
National Provider Identifier
1760985600
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-00478 Issued in NC
Practice address
555 Carthage St
Sanford, NC 27330-4104
Phone
(919) 774-6518
NPI assigned
Mar 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021-00478 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X UT

Addresses

Primary practice location

555 Carthage St
Sanford, NC 27330-4104

Mailing address

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

Other practice location 1

475 W 940 N
Provo, UT 84604-3301
Phone (801) 357-7686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707000060 NC Practitioner - Family Practice 2365779428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-00478NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

8 Regional Cir
Pinehurst, NC 28374
Phone (910) 215-5555

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

1411 Greenway Ct
Sanford, NC 27330
Phone (919) 292-1878

555 Carthage St
Sanford, NC 27330
Phone (919) 774-6518

Interoperability endpoints

  • Direct secure messaging: chasetonnielsen@phmc.allscriptsdirect.net

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.

Hospital & facility affiliations 9

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": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1760985600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304104",
            "telephone_number": "919-774-6518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304104",
            "telephone_number": "919-774-6518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 W 940 N",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043301",
            "country_code": "US",
            "telephone_number": "801-357-7686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "CHASETON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-00478",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.