Active NPI
Douglas Franklin Chitsey, D.D.S.
- General Practice Dentistry
- San Angelo, TX
National Provider Identifier
1871504555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18076
- Practice address
- 3419 Johnson Ave
San Angelo, TX 76904-5554 - Phone
- (325) 949-9696
- Fax
- (325) 949-7989
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18076 | TX | Primary |
Addresses
Primary practice location
3419 Johnson Ave
San Angelo, TX 76904-5554
Mailing address
3419 Johnson Ave
San Angelo, TX 76904-5554
Phone (325) 949-9696
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D18076 | Other | TX | BCBS |
| 824601 | Other | TX | UNITED CONCORDIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 19, 2016 through Apr 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18076 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871504555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3419 JOHNSON AVE",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769045554",
"telephone_number": "325-949-9696",
"fax_number": "325-949-7989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3419 JOHNSON AVE",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769045554",
"telephone_number": "325-949-9696",
"fax_number": "325-949-7989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHITSEY",
"first_name": "DOUGLAS",
"middle_name": "FRANKLIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "18076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "D18076",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "824601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.