Organization Active NPI

David a Chappell MD, Medical Corporation

  • Endocrinology, Diabetes & Metabolism Physician
  • Petaluma, CA
National Provider Identifier
1821267162
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
C40326 Issued in CA
Legal business name
DAVID A CHAPPELL MD, MEDICAL CORPORATION
Practice address
141 Lynch Creek Way
Suite a
Petaluma, CA 94954-2341
Phone
(707) 762-0001
Fax
(707) 765-0666
NPI assigned
Feb 20, 2008
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Dr. David Chappell, MDNPI 1598732463
Title
Doctor
Phone
(707) 762-0001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X C40326 CA Primary

Addresses

Primary practice location

141 Lynch Creek Way
Suite a
Petaluma, CA 94954-2341

Mailing address

141 Lynch Creek Way
Suite a
Petaluma, CA 94954-2341
Phone (707) 762-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000551 CA Part B Supplier - Clinic/Group Practice 4587742390 Receives reassigned benefits from 1 practitioner
Practice locations: Petaluma, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0947611David Chappell MD Medical Corporation141 Lynch Creek Way, Ste a, Petaluma, CA 94954Certificate of waiverJun 18, 2028

National Provider Directory

National Provider Directory

Locations

141 Lynch Creek Way
Petaluma, CA 94954
Phone (707) 763-0802

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1821267162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LYNCH CREEK WAY",
            "address_2": "SUITE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542341",
            "telephone_number": "707-762-0001",
            "fax_number": "707-765-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LYNCH CREEK WAY",
            "address_2": "SUITE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542341",
            "telephone_number": "707-762-0001",
            "fax_number": "707-765-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A CHAPPELL MD, MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "CHAPPELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "707-762-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "C40326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.