Active NPI
Timothy R Chamberlain, M.D.
- Surgery Physician
- Columbia City, IN
National Provider Identifier
1871541375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 01033472A
- Practice address
- 344 N. Main St.
Columbia City, IN 46725 - Phone
- (260) 248-2575
- Fax
- (260) 248-2726
- NPI assigned
- May 5, 2006
- Last updated
- Mar 19, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1033472 | IN | |
| Surgery Physician | 208600000X | 01033472A | IN | Primary |
Addresses
Primary practice location
344 N. Main St.
Columbia City, IN 46725
Mailing address
1234 E. Dupont Rd.
Suite 3
Fort Wayne, IN 46825-1545
Phone (260) 373-9700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00732002 | Other | IN | RAILROAD MEDICARE |
| 000000603874 | Other | IN | ANTHEM |
| 85760 | Other | IN | ANTHEM BCBS |
| 020004909 | Other | IN | RAILROAD MEDICARE |
| 100263100 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1033472 | IN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1871541375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1234 E. DUPONT RD.",
"address_2": "SUITE 3",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251545",
"telephone_number": "260-373-9700",
"fax_number": "260-373-9740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "344 N. MAIN ST.",
"city": "COLUMBIA CITY",
"state": "IN",
"postal_code": "46725",
"telephone_number": "260-248-2575",
"fax_number": "260-248-2726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERLAIN",
"first_name": "TIMOTHY",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IN",
"license": "1033472",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01033472A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00732002",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000603874",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "85760",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020004909",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100263100",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.