NPIMap

Individual provider Active NPI

Rachael L Chambers, DO

  • Family Medicine Physician
  • Hayward, WI
National Provider Identifier
1912976952
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50778-21 Issued in WI
Practice address
11134 North Hwy 77
Hayward, WI 54843
Phone
(715) 634-5505
NPI assigned
Mar 14, 2006
Last updated
May 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47631 MN
Family Medicine Physician 207Q00000X 50778-21 WI Primary

Addresses

Primary practice location

11134 North Hwy 77
Hayward, WI 54843

Mailing address

11134 North Hwy 77
Hayward, WI 54843
Phone (715) 634-5505

Other identifiers 3

IdentifierTypeStateIssuer
01-21845OtherMNMEDICA
261P3CHOtherMNBCBSMN
757133000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071228000117 WI Practitioner - Family Practice 2062445661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

10405 Vermont Ave
Hayward, WI 54843-6111
Phone (715) 699-1355

11134 N State Rd
Hayward, WI 54843-5325
Phone (715) 634-5505

15495 County Rd B
Hayward, WI 54843-3438
Phone (715) 634-2641

1615 Maple LN
Suite 1
Ashland, WI 54806-3630
Phone (715) 685-7500

3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 392-8281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50778-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior Current Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD CurrentSince Oct 15, 2007 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Oct 15, 2007 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
St Mary's Hospital of Superior CurrentSince Jan 1, 2017 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jan 1, 2017 Accepting new patients

Locations

200 Bunker Hill Dr
Aitkin, MN 56431
Phone (218) 927-2121

330 N 8th Ave E
Duluth, MN 55805
Phone (218) 529-9122

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

15495 County Road B
Hayward, WI 54843
Phone (715) 634-2641

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

Organizations & group practices 7

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1912976952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11134 NORTH HWY 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "54843",
            "telephone_number": "715-634-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11134 NORTH HWY 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "54843",
            "telephone_number": "715-634-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "RACHAEL",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "47631",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "50778-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-21845",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "261P3CH",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "757133000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

Verify at the official NPI Registry.