NPIMap

Individual provider Active NPI

Jeffery Lee Chamberlain, M.D.

  • Family Medicine Physician
  • Byron Center, MI
National Provider Identifier
1790905214
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301086292 Issued in MI
Practice address
2373 64TH St SW
Suite 1300
Byron Center, MI 49315-7974
Phone
(616) 685-1350
Fax
(616) 261-7191
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301086292 MI Primary

Addresses

Primary practice location

2373 64TH St SW
Suite 1300
Byron Center, MI 49315-7974

Mailing address

245 State St SE
Grand Rapids, MI 49503-4328
Phone (616) 685-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20071012000681 MI Practitioner - Family Practice 8224124789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2373 64TH St SW
Suite 1300
Byron Center, MI 49315-7975
Phone (616) 685-1350

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 1, 2010 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Jul 1, 2010 Accepting new patients
Saint Mary's Health Services Past Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients
Trinity Health - Michigan Past Accepting new patients
Advantage Health Physicians PC Family Medicine Past Accepting new patients

Locations

2373 64th St SW
Ste 1300
Byron Center, MI 49315
Phone (616) 685-1350

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

245 State St SE
Grand Rapids, MI 49503
Phone (616) 685-1808

245 State St SE
Ste 1A
Grand Rapids, MI 49503

300 Lafayette Ave SE
Ste 4000
Grand Rapids, MI 49503
Phone (616) 685-6741

3380 44th St SW
Grandville, MI 49418
Phone (616) 685-8250

Interoperability endpoints

  • Direct secure messaging: jchamberlain26091@direct.trinity-health.org
  • Direct secure messaging: jeffery.chamberlain.1@8589.direct.athenahealth.com

Organizations & group practices 6

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 4

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1790905214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328",
            "telephone_number": "616-685-1808",
            "fax_number": "616-685-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 64TH ST SW",
            "address_2": "SUITE 1300",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157974",
            "telephone_number": "616-685-1350",
            "fax_number": "616-261-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "JEFFERY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301086292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.