Individual provider Active NPI

Vernon Robert Chin, M.D.

  • Hospitalist Physician
  • Dalton, GA
National Provider Identifier
1881891232
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
063408 Issued in GA
Practice address
1200 Memorial Dr
Dalton, GA 30720-2529
Phone
(706) 217-2207
NPI assigned
Jun 29, 2007
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63408 GA
Hospitalist Physician 208M00000X 063408 GA Primary

Addresses

Primary practice location

1200 Memorial Dr
Dalton, GA 30720-2529

Mailing address

1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Phone (706) 879-4776

Other practice location 1

1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Phone (706) 879-4776

Other practice location 2

1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Phone (706) 879-4776

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20101110000070 GA Practitioner - Internal Medicine 1153516620 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

550 Peachtree St NE
Atlanta, GA 30308-2212
Phone (404) 364-7285

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63408GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Feb 1, 2015 Accepting new patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Nov 4, 2019 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Feb 1, 2015 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist CurrentSince Nov 1, 2019 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1881891232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 RED BUD RD NE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307016010",
            "telephone_number": "706-879-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-217-2207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Red Bud Rd NE",
            "address_purpose": "LOCATION",
            "city": "Calhoun",
            "state": "GA",
            "postal_code": "307016010",
            "country_code": "US",
            "telephone_number": "706-879-4776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Red Bud Rd NE",
            "address_purpose": "LOCATION",
            "city": "Calhoun",
            "state": "GA",
            "postal_code": "307016010",
            "country_code": "US",
            "telephone_number": "706-879-4776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "VERNON",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "63408",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "063408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3650 Steve Reynolds Blvd",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300964506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.