Mark S Chandler, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0033963 Issued in NC

Practice address

109 Bradford Ave
Fayetteville, NC 28301-5401

Phone

(910) 323-0601

Fax

(910) 222-6422

NPI assigned

Dec 28, 2006

Last updated

Jul 8, 2007By 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 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Brody School of Medicine at East Carolina University, 1986

Medicare assignment

May accept Medicare assignment

Group practices

Integrated Behavioral Healthcare Services, PAGroup PAC ID 8729040316, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Integrated Behavioral Healthcare Services, PA

  • Psychologist
  • Fayetteville, NC
  • NPI 1689842551

  Psychiatry

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871659557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BRADFORD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015401",
            "telephone_number": "910-323-0601",
            "fax_number": "910-222-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BRADFORD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015401",
            "telephone_number": "910-323-0601",
            "fax_number": "910-222-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "0033963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "819010V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Chan
• Renea Michelle Chance, CPT
• Michelle Lynn Chancey
• Ashley Garland Chandler, PT
• Bridget Renee Chandler
• Dinesh Narasimhaiah Chandra, M.D.
• Naomi S Chang, LAT, LMBT
• Changing Lives Home Care
• Changing Outcomes, LLC
• Changing Places Therapeutic Center, Company

• Psychiatry Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Psychiatry Physician in North Carolina

• 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.
• 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.