Individual provider Active NPI

Donald L Chaffin Jr., M.D.

  • Family Medicine Physician
  • Inez, KY
National Provider Identifier
1902849912
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22840 Issued in KY
Practice address
3165 Blacklog Rd
Inez, KY 41224-9113
Phone
(606) 298-7772
Fax
(606) 298-7564
NPI assigned
Jun 14, 2006
Last updated
May 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22840 KY Primary

Addresses

Primary practice location

3165 Blacklog Rd
Inez, KY 41224-9113

Mailing address

PO Box 1311
Inez, KY 41224-1311
Phone (606) 298-7772

Other identifiers 1

IdentifierTypeStateIssuer
64228406MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050323000303 KY Practitioner - General PracticePractitioner - Family Practice 1456307446 Reassigns benefits to 1 organization
Practice locations: Inez, KY

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin County Rural Health Clinic PLLCGroup PAC ID 9436372141, 9 clinicians

Practice addresses (Care Compare)

64 Kirk PLZ
Inez, KY 41224-6501
Phone (606) 298-2520

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin County Rural Health Clinic PLLC CurrentSince Mar 1, 2019 Accepting new patients
Blacklog Apothecary Inc PastSince Nov 14, 1994 Accepting new patients

Locations

64 Kirk Plz
Inez, KY 41224
Phone (606) 298-2520

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.

Hospital & facility affiliations 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1902849912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1311",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412241311",
            "telephone_number": "606-298-7772",
            "fax_number": "606-298-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 BLACKLOG RD",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412249113",
            "telephone_number": "606-298-7772",
            "fax_number": "606-298-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFIN",
        "first_name": "DONALD",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "22840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64228406",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inez, KY

Sources for this page

Verify at the official NPI Registry.