Individual provider Active NPI

Harvey E Chambers, CP

  • Clinical Neuropsychologist
  • Fayetteville, AR
National Provider Identifier
1871527267
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
93-19P Issued in AR
Practice address
2592 N Gregg Ave Ste 16
Fayetteville, AR 72703-5541
Phone
(479) 313-6333
Fax
(479) 313-6168
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 93-19P AR Primary
Clinical Psychologist 103TC0700X 9319P AR

Addresses

Primary practice location

2592 N Gregg Ave Ste 16
Fayetteville, AR 72703-5541

Mailing address

2592 N Gregg Ave Ste 16
Fayetteville, AR 72703-5541
Phone (479) 313-6333

Other identifiers 1

IdentifierTypeStateIssuer
123650719MedicaidAR

Other names 1

  • Gene Chambers Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617001202 AR Practitioner - Clinical Psychologist 8820071368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2592 N Gregg Ave
Suite 16
Fayetteville, AR 72703-5541
Phone (479) 313-6333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93-19PARMDClinical Neuropsychologist
9319PARMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gene Chambers PHD PLLC Clinical Neuropsychologist CurrentSince Nov 1, 2016 Accepting new patients
Jeffrey L Tate MD PA Past Accepting new patients

Locations

2592 N Gregg Ave
Ste 16
Fayetteville, AR 72703
Phone (479) 313-6333

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1871527267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 N GREGG AVE STE 16",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035541",
            "telephone_number": "479-313-6333",
            "fax_number": "479-313-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 N GREGG AVE STE 16",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035541",
            "telephone_number": "479-313-6333",
            "fax_number": "479-313-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "HARVEY",
        "middle_name": "E",
        "credential": "CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "93-19P",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "9319P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123650719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENE",
            "last_name": "CHAMBERS",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.