Active NPI
Stephen Chakmakjian, MD
- Pediatrics Physician
- Waco, TX
National Provider Identifier
1770566333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- L5700
- Practice address
- 601 W State Highway 6
Suite 102
Waco, TX 76710-5591 - Phone
- (254) 399-8364
- Fax
- (254) 399-9116
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | L5700 | TX | Primary |
Addresses
Primary practice location
601 W State Highway 6
Suite 102
Waco, TX 76710-5591
Mailing address
PO Box 7655
Waco, TX 76714-7655
Phone (254) 751-9669
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 157839502 | Medicaid | TX | |
| 850520 | Other | TX | BLUE CROSS BLUE SHIELD |
| 201581079 | Other | TX | TRICARE |
| 157839502 | Other | TX | SUPERIOR CHIP |
| 84506 | Other | TX | SCOTT & WHITE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L5700 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heart of Texas Pediatrics | Pediatrics | Past | Accepting new patients |
| Central Texas Cardiovascular | Past | Accepting new patients | |
| Hillcrest Family Health Center | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/1902/brand/6/csg/45/fhir/r4
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.
-
- Specialist
- Waco, TX
- NPI 1811900848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237507200000",
"number": "1770566333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7655",
"city": "WACO",
"state": "TX",
"postal_code": "767147655",
"telephone_number": "254-751-9669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W STATE HIGHWAY 6",
"address_2": "SUITE 102",
"city": "WACO",
"state": "TX",
"postal_code": "767105591",
"telephone_number": "254-399-8364",
"fax_number": "254-399-9116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKMAKJIAN",
"first_name": "STEPHEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2009-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "L5700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "157839502",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "850520",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "201581079",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR CHIP",
"identifier": "157839502",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SCOTT & WHITE",
"identifier": "84506",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.