Individual provider Active NPI

Dareshia F Chambers-Staple, PA

  • Physician Assistant
  • Danville, IL
National Provider Identifier
1780104877
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
311 W Fairchild St
Danville, IL 61832-3876
Phone
(217) 431-7650
Fax
(217) 431-7634
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL Primary

Addresses

Primary practice location

311 W Fairchild St
Danville, IL 61832-3876

Mailing address

611 W Park St
Urbana, IL 61801-2529
Phone (217) 383-6941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20171102000737 IL Practitioner - Physician Assistant 7810253143 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Jul 30, 2023 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 10, 2017 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 10, 2017 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

311 W Fairchild St
Danville, IL 61832
Phone (217) 431-7600

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

801 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: dchambersstaplepa231812@carlehiedirect.net

Organizations & group practices 5

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1780104877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W FAIRCHILD ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323876",
            "telephone_number": "217-431-7650",
            "fax_number": "217-431-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS-STAPLE",
        "first_name": "DARESHIA",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.