Chamberlain General Surgery PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

O-194 Issued in ID

Legal business name

CHAMBERLAIN GENERAL SURGERY PA

Practice address

2805 Valencia Drive
Idaho Falls, ID 83404

Phone

(208) 528-6500

Fax

(208) 525-6151

NPI assigned

Sep 20, 2006

Last updated

Apr 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David J Chamberlain, D.O.NPI 1366465197

Title

President

Phone

(208) 528-6500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David J Chamberlain, D.O.

  • Surgery Physician
  • Idaho Falls, ID
  • NPI 1366465197
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1770680191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 E MAJESTIC VW",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834068179",
            "telephone_number": "208-528-6500",
            "fax_number": "208-525-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 VALENCIA DRIVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-528-6500",
            "fax_number": "208-525-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMBERLAIN GENERAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-528-6500",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "O-194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Aesthetics PC
• Center for Sight PLLC
• Center for Surgery PLLC
• Center for Vision and Learning, PLLC (Center for Vision and Learning)
• Maria Teresa Cervantes-Fullmer, FNP
• David J Chamberlain, D.O.
• John D Chambers Jr., M.D.
• Mark Aaron Chambers, DDS
• Jon F Champlin, CRNA
• Kenna Chancey, LCSW

• Surgery Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.