Kendall Yazzie Redhorse Chambellan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 01658 Issued in TX

Practice address

811 S Washington Ave
Marshall, TX 75670

Phone

(903) 315-1488

NPI assigned

Jun 24, 2005

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mr. Ken Chambellan Other name

Medicare fee-for-service enrollment

Enrolled in TX, HI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vein Clinics of Hawaii, LLCGroup PAC ID 9436395142, 5 clinicians

Hawaii Emergency Physicians Associated IncGroup PAC ID 2860390283, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6966/brand/1/csg/1/fhir/r4
• Direct secure messaging: kchambellan194661@christushealth.direct-ci.net

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.

• Hawaii Emergency Physicians Associated Inc

  dba HEPA, Inc.

  • Emergency Medicine Physician
  • Kailua, HI
  • NPI 1801843198
  Medicare reassignment Care Compare group NPD
• Vein Clinics of Hawaii LLC

  • Vascular Surgery Physician
  • Kamuela, HI
  • NPI 1528307006
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Comprehensive Hospitalist Services of Texas PLLC

  • Hospitalist Physician
  • Odessa, TX
  • NPI 1295062198
  Medicare reassignment NPD
• North Texas Physician Services, PLLC

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1992586150
  Medicare reassignment
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Exceed Health Clinic

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1780277731
  NPD (past)
• Third Coast Emergency Physicians Sid Peterson PA

  • Emergency Medicine Physician
  • Kerrville, TX
  • NPI 1972541423
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1861498768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S WASHINGTON AVE",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "75670",
            "telephone_number": "903-315-1488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "TX",
            "postal_code": "75670",
            "country_code": "US",
            "telephone_number": "903-315-1488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBELLAN",
        "first_name": "KENDALL",
        "middle_name": "YAZZIE REDHORSE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA 01658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192935811",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02237142",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "794785",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "CHAMBELLAN",
            "prefix": "MR.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carl R Turner (Carl R. Turner Rural Health Clinic)
• Latonya Carter, MED., CCC-SLP
• Casce House
• Shannon Marie Cash, FNP
• John Carrell Cayce, DENTIST DDS
• West Chandler, MD
• Changing Lives Behavioral Health
• Jeri Kellett Charles, FNP
• Toney Lee Charles Jr., PHD
• Choices Adolescent Treatment Ctr

• Physician Assistant in Marshall, TX
• Providers in Marshall, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.