Individual provider Active NPI

Regis R Chamberlin, MD

  • Pediatrics Physician
  • Wisconsin Rapids, WI
National Provider Identifier
1922114255
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
27178 Issued in WI
Practice address
2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone
(715) 423-0122
NPI assigned
Aug 21, 2006
Last updated
Apr 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 27178 WI Primary

Addresses

Primary practice location

2031 Peach St
Wisconsin Rapids, WI 54494-5181

Mailing address

2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone (715) 423-0122

Other identifiers 1

IdentifierTypeStateIssuer
30665900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20051130000668 WI Practitioner - Pediatric Medicine 2668462821 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27178WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medical Group, Inc. CurrentSince Jun 6, 2011 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jun 6, 2011 Accepting new patients
Aspirus Wausau Hospital, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

501 Aurora St
Antigo, WI 54409
Phone (715) 623-2331

2720 Plaza Dr
Ste 1400A
Wausau, WI 54401
Phone (715) 847-0426

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

2031 Peach St
Wisconsin Rapids, WI 54494
Phone (715) 423-0122

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1922114255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 PEACH ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945181",
            "telephone_number": "715-423-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 PEACH ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945181",
            "telephone_number": "715-423-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLIN",
        "first_name": "REGIS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "27178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30665900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.